Tumour Markers

AFP

40 mg/L

CA 125

35 U/mL

CA 15.3

31 U/mL

CA 19.9

37 U/mL

CEA

< 5g/L

hCG

< 5 IU/L

PSA

< 4.0 pg/L

Thyroid

Lung

Prostate

Testis

Liver

Colon

Pancreas

Ovary

Breast

Serum tumour markers are generally best used in monitoring people with known cancer. False positive and
negative results are often a problem when these are used in screening. Always try to use the same laboratory
when monitoring a cancer patients tumour marker levels because changes in laboratory methods can cause
unexpected and misleading changes in the blood results.
Tumou Normal
Comments
r
Range
Marke
rs
Alpha-foetoprotein is a yolk sac protein made by heptatocellular
carcinoma, testicular and germ cell tumours. Levels may be
increased in hepatitis and chronic liver disease. Also increased in
pregnant women and children less than one year of age.
Increased in 70-80% ovarian cancinomas. Not sensitive enough for
screening. Levels lower after menopause. Increased CA 125 seen
with ascites from any cause, during menstration, with benign
ovarian cysts, endometriosis and liver disease.
Increased in women with breast cancer and may be used to follow
their response to treatment. Also increased with some pancreatic,
lung, colotectal or ovarian cancer. Approximately 5% of normal
women will have CA 15.3 > 25 Ku/L, 23% of women with primary
breast cancer and 69% of those with metastatic disease. Not
suitable for screen because of low sensitivity. Increased in liver
disease.
Used to monitor carcinoma of the pancreas or other
gastrointestinal malignanies. Normal in at least 30% of people
with pancreatic cancer. Values >1000kU/L often indicate cancer
although increases are seen in cholangitis, cirrhosis, pancreatitis
and cystic fibrousis. Non-malignant increases often <120 kU/L.
The marker is no use in the 5% of the population who are negative
for the relatedLewis La blood group antigen.
Carcinoembbryonic antigen may be increased with
gastrointestinal, lung and breast cancer. Levels are higher with
more advanced cancer of colon- 78% of people with Dukes Stage
A will have normal results. Maybe useful detecting relapse of colon
cancer after treatment. Not suitable for screening.Increased in
benign conditions. (eg. Cirrhosis, emphysema, benign breast
disease) typically 15-20 pg/L.
Produced by trophoblast tumours such as choriocarcinoma and by
some testicular tumours. Increased in normal pregnancy.
Prostate specific antigen widely used in the diagnosis and
monitoring of prostate cancer. NB. Not all men with prostate
cancer have increased PSA. Increased PSA is seen in benign
prostatic hypertrophy, prostatitis, ejectulation, recent prostate
biopsy or surgery. Free/toal PSA ratios can be used to decide which
men with small increases (2.5 to 10 pg/L) need follow up.

Free/total PSA ratio <8% is suggestive of cancer, >28% suggests

BPH.
-sometimes

-often