For BMLS 2016 soon-to-be RMTs 2016

Tumor markers: Just short descriptions for simple-recall

CHO & CA Antigens DIAGNOSTIC SIGNIFICANCE

1. CA 19-9 Monitoring pancreatic cancer and some GIT tumors

2. CA 15-3
Monitoring breast cancers and therapy
3. CA 27-29

predominantly used to monitor therapy and to distinguish benign masses from ovarian
4. CA-125 cancer
only clinically accepted serologic marker of ovarian cancer

??? What is oncofetal Antigen?

Oncofetal Antigens DIAGNOSTIC SIGNIFICANCE

1. CEA Most widely used tumor marker for colorectal cancer

Note: High in smokers, liver damage, lung, breast and GIT tumors

2. AFP Diagnosis, staging, prognosis, and treatment monitoring of hepatocellular carcinoma (HCC; i.e. hepatoma).
Note: AFP is not completely specific for HCC
might be increased in pregnancy & benign liver disease
Classification and monitoring therapy for nonseminomatous testicular cancer in combination with another tumor
marker: -human chorionic gonadotropin (-hCG)

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ENZYME DIAGNOSTIC SIGNIFICANCE

Determination of liver and bone involvement (non-specific)

1. ALP
Metastatic CA of bone, hepatocellular carcinoma, osteosarcoma, lymphoma, leukemia

Prostatic adenocarcinoma
2. ACP
Diagnose and monitor prostate cancer but may not necessarily be found when malignancy is present

3. PSA Prostate CA screening, therapy monitoring and recurrence

Hematologic malignancies
Nonspecific marker
4. LDH LD-1: germ cell tumors
LD-3: leukemias and lymphomas
LD-5: colon, breast, lung, liver, stomach cancers

Neuroendocrine System
5. NSE Neuroblastoma, neurogenic tumors, small cell carcinoma of the lung, glucagonomas, insulinomas,
carcinoid tumors, and phaeochromocytoma

Associated with pancreas

6. AMS, LPS, TRYPSIN, AND
May be elevated in pancreatic tumors
RIBONUCLEASE
RNAse may also be elevated in breast, colon, stomach, liver, and lung cancers

CK-BB Isoenzyme
7. CK Malignant diseases - those of epithelial cell origin
Measured in CSF brain tumors (nonspecific)

8. 5N More sensitive markers for liver cancer than ALP

Neither is specific for cancer

9. Terminal Deoxynucleotidyl Found in immature lymphoid cells

To predict prognosis and responsiveness to drugs
Transferase (TdT)
To help classify leukemia and non-Hodgkins Lymphoma

Sherazo 2016
 10. Collagenase and Cathepsin Synthesized and secreted by malignant cells
Responsible for degrading the extracellular matrix and thus permitting their invasion and
D
metastasis

11. Histaminase & Diamine

Medullary thyroid cancer to confirm high level of calcitonin
oxidase

12. Muramidase & Lysozyme Monitoring of monocytic and myelomonocytic leukemias

HORMONES DIAGNOSTIC SIGNIFICANCE

Trophoblastic CA, chorionic CA, germ cell tumors of the ovary and testis
1. HCG
Occasionally elevated in ovarian CA and some lung CA

a.k.a. Thyrocalcitonin
2. Calcitonin Action is antagonistic to PTH
Elevated in medullary thyroid cancer

Pituitary and ectopic ACTH-secreting tumors

Cushings Syndrome (hypercortisolism)
3. ACTH
Ectopic-ACTH producing tumor
Small cell CA of the lung
Epinephrine and Norepinephrine

4. Catecholamines & their Metanephrine, normetanephrine, 3-methoxytyramine, vanillylmandelic acid (VMA), and homovanillic acid (HVA)
metabolites
Phaeochromocytoma (adult) and neuroblastoma (infants and children)

Paraganglioma

Serotonin (5-Hydroxytryptamine) enterochromaffin cells of the GIT and brain

5. Serotonin and 5-
Vasoconstrictor and carried largely by platelets and metabolized to 5-HIAA
hydroxyindole-3-acetic acid
Carcinoid tumor and argentaffinomas

Sherazo 2016
 SIADH; pancreatic, duodenal, and adrenal malignancies
6. ADH
Small cell carcinoma of the lung

Secreted by G cells of the stomach and duodenum and D cells of the pancreas

Stimulates secretion of gastric acid by the parietal cells and pepsinogen and intrinsic factor by the mucosal cells
7. Gastrin of the stomach

Gastrin-secreting duodenal and pancreatic tumors (gastrinomas) are responsible for a condition called Zollinger-
Ellison Syndrome

8. Glucagon Glucagonomas glucagon-secreting tumors of the pancreas

9. Insulin Insulinomas insulin-secreting tumors of the pancreas

Secreted by the lactotropic cells of the anterior pituitary, for lactation by the mammary glands
10. Prolactin (PRL)
Pituitary adenomas can cause hyperprolactinemia, which in turn can cause galactorrhea

Estrogen-secreting tumors of ovarian in origin

11. Estrogen & Androgens
Estrogen-secreting tumors of the testis, the adrenal cortex, and chorioepithelium

Trophoblastic tumors
12. TSH
Some tumors of the prostate, lung, blood, and pituitary

Human Chorionic Somatomammotropin

13. HPL
Gestational, gonadal, and extragonadal trophoblastic cancers

GH-secreting tumors of the pituitary cause acromegaly in adults and pituitary gigantism in children
14. GH
Pituitary adenoma

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15. PTH Hypercalcemia is associated with bone metastasis

16. Erythropoietin Erythrocytosis and polycythemia

17. Renin & Aldosterone Renin-secreting tumors of the kidney

18. Chromagranin A Pheochromocytoma, neuroblastoma, carcinoid tumors, small cell lung CA

19. C-peptide Insulin-secreting tumors

Sherazo 2016