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Clinical Pathology > Tumor Markers > Flashcards

Tumor Markers Flashcards

1
Q

What is a tumor marker❓

A

Could include hormones, antigens, enzymes etc that are produced directly by a tumor or as an effect of a tumor on health tissue

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2
Q

An ideal tumor marker…

A

Released directly in bloodstream

Detectable at small concentrations

Tumor specific

Absent in healthy individuals

Detectable in body fluids

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3
Q

The concentration of a tumor marker increases with its progression

True or false

A

True

Highest levels are seen in metastasis

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4
Q

The most common method for the detection of tumor markers is❓

What are the challenges associated with this❓

A

1.
Immunoassays

  1. Markers are often above linearity
    Hook effect

Heterophile antibodies

Lipemia, hemolysis and antibody cross reactivity

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5
Q

⬆️Alkaline phosphatase is increased in what cancers❓

A

Primary or secondary liver cancers

It may be helpful in evaluating metastasis with bone or liver involvement

ALP is also seen in the Intestine

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6
Q

Creative kinase is an enzymatic tumor marker for what cancers❓

A 
Breast 
Ovarian 
Lung
Colon 
Prostate
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7
Q

Lactate dehydrogenase is an enzymatic tumor marker for what cancers❓

A

Liver
Lymphomas
Leukemias

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8
Q

Prostatic acid phosphatase is an enzymatic tumor marker for what cancers❓

A

Prostate cancer

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9
Q

Placental ALP, Regan isoenzyme is seen in what cancers❓

A

Lung
GI cancers
Ovarian ca
Hodgkin’s disease

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10
Q

⬆️prostatic acid phosphatase may be observed in what conditions❓

A

Prostate cancer (used in staging and monitoring tx)
Osteogenic sarcoma
Multiple myeloma
Bony metastasis

Osteoporosis
Hyperthyroidism

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11
Q

PAP has been replaced by PSA test.

  1. True or false❓
  2. Why❓
  3. What could falsely elevate PSA levels in serum ❓
A

True

More specific for screening and detection of early cancer

Urinary bladder cateterization
Digital recital examination

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12
Q

How would you differentiate between prostatic cancer and benign prostatic hyperplasia❓

A

The ratio between free and total PSA levels is a reliable market for differentiation

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13
Q

What tests would you run in order to correctly diagnose prostatic cancer❓

A

PSA test
DRE
Transrectal ultrasonography

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14
Q

The treatment of prostatic cancer should include❓

A

Radical prostatectomy
Radiation therapy
Antiandrogen therapy

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15
Q

If PSA levels are still high after 2/3weeks of treating a prostatic cancer, should it be assumed that a residual tumor is present❓

A

Yes

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16
Q

Androgen deprivation therapy may have a direct effect on the PSA level that is independent of the antitumor effect

True or false

A

True

17
Q

Calcitonin is a hormonal tumor marker associated with which cancers❓

A

•Medullary thyroid cancer

Also seen in:
Lung 
Breast 
Kidney 
Liver 
And in non malignant states like:
Pulmonary diseases 
Pancreatitis 
Paget’s disease 
Hyperthyroidism 
Pregnancy 
Myeloproliferative disorders
18
Q

Human chorionic gonadotropin is elevated in what tumors❓

A

Trophoblastic tumors

Chriocarcinoma

Germ cell tumors of ovary and testis

19
Q

Oncofetal antigens are normal in fetal development then re-expressed in tumor growth

True or false❓
List some examples

A

True

CEA (Carcino-embryonic antigen)
Alpha-feta protein

20
Q

CEA is caused clinically to diagnose❓

It can also be elevated in what conditions❓

A 
1. 
Lung 
Breast 
GI
Colorectal ca 
2. 
In smokers 
Cirrhosis 
Rectal polips
Ulcerative colitis 
Benign breast disease
21
Q

Should CEA be used for screening❓

A

No

It’s useful in staging and monitoring tumors

22
Q

Alpha fetoprotein is synthesized by fetal liver and re-expressed in certain types of tumors

True or false❓
Diagnostic significance❓

A

True; functions as transport protein and regulates oncotic pressure

Hepatocellular carcinoma
Germ cell tumors of ovary and testis

23
Q

Is AFP useful in screening of cancers❓

What is the reference range ❓

A

Yes

> 1000 is diagnostic of cancer except in pregnancy

24
Q

AFP is a prognostic indicator of survival

True or false

A

True

<10microgram/L in healthy adults

25
Q

Elevated AFP is associated with shorter survival time

True or false

A

True

26
Q

Which hormonal tumor markers are used in classifying and staging germ cell tumors❓

A

AFP

hCG

27
Q

What are carbohydrate tumor markers❓

Give examples

A

HMW mucins/Blood Group Antigens on tumor cell surface or secreted by tumor cells

CA 15-3
CA 19-9
CA 125

28
Q

What is CA 15-3 used for❓

A

A marker for breast carcinoma

🚫diagnosis
✅monitoring treatment

May also be found in patients with: 
Lung 
Pancreatic 
Colorectal 
Liver 
Ovarian ca
29
Q

CA 125 is a nonspecific marker for❓

It may also be elevated in what cases❓

A
  1. Ovarian
    Endometrial ca
2.
Lung 
Breast 
Colorectal 
Pancreatic ca 
Cirrhosis 
Hepatitis 
Endometriosis 
Pericarditis 
Early pregnancy
30
Q

Which tumor marker can be used in differentiating a benign ovarian mass form a malignant ovarian mass❓

A

CA 125

31
Q

The use of CA 125 as a detection for reoccurrence is ____ accurate❓

A

75%

32
Q

CA 19-9 is a marker and monitor for❓

It may also be elevated in what cases❓

A

1.
Colorectal
Pancreatic ca

2.
Hepatocellular 
Hepatobiliary 
Gastric
Breast ca

Pancreatitis
Benign GI diseases

33
Q

Beta-microglobulin is a protein marker for❓

It may also be elevated in what cases❓

A
  1. Multiple myeloma
    Hodgkin lymphoma
  2. Chronic inflammation
    Viral hepatitis
34
Q

Ferritin is a protein marker for❓

A 
Hodgkin lymphoma 
Leukemia 
Liver 
Lung 
Breast ca
35
Q

Thyroglobulin is a protein marker for❓

A

Differentiated thyroid cancer

36
Q

Monoclonal immunoglobulin is a protein marker for❓

A

Multiple myeloma

37
Q

Bence-Jones protein is a free monoclonal immunoglobulin light chain in the urine, it is reliable marker for❓

A

Multiple myeloma

38
Q

It has been observed that patients with +ve estrogen and progesterone receptor markers tend to respond to breast cancer treatment

What % of breast cancer patients have estrogen receptors❓

Do patients with +ve receptor levels survive longer❓

A

60%,

Yes, 2/3rd of px with estrogen + respond to hormonal therapy

5% with estrogen -ve respond

Clinical Pathology (6 decks)

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