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What are the 5 types of tumor markers?
- Antigens
- Enzymes
- Hormones
- Oncogenes
- Tissue Receptors
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Alpha-Fetoprotein (AFP)
- ANTIGEN
- Associated with Hepatocellular carcinoma (HCC)
- Used for screening in patients w/cirrhosis or hepatitis
- Can also be elevated in non-seminoma germ cell cancers
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Bence-Jones Proteins
- ANTIGEN (found in urine)
- Associated with Multiple Myeloma (detection/monitoring)
- Not found on routine UA, need protein electrophoresis
- Indicates plasma cell degeneration
- Can also be elevated in leukemia, lymphoma & bone mets.
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Beta-HCG
- HORMONE (usually only positive in pregnancy)
- Associated w/Hydatidiform mole of uterus, Choriocarcinoma of uterus or germ cell tumors of ovaries
- Pathognomonic for germ cell neoplasm in males
- Can also be elevated in hepatoma
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Cancer Antigen 19-9 (CA 19-9)
- ANTIGEN
- Elevated with pancreatic & hepatobiliary cancer
- Rapid increase can indicate recurrence in treated patients
- 5% cannot make the protein
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Cancer Antigen-125 (CA-125)
- ANTIGEN
- Elevated in ovarian cancer (80 - 90%)
- Good prognostic indicator: precipitous fall after 2 cycles of chemo
- Rise in levels is good early predictor of recurrence
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Carcinoembryonic Antigen (CEA)
- ANTIGEN
- GI cancers, CRC (extent, prognosis, response to tx)
- Also found in other cancers (breast, SCLC, other GI cancers)
- Smokers have elevated baseline levels
- 20% of CRC/breast cancer patients do not make CEA
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Prostate Specific Antigen (PSA)
- ANTIGEN
- Screening/response to tx/recurrence for prostate cancer
- High sensitivity, low specificity (infection, enlargement, inflammation can also raise PSA)
- Have to double levels if patient is taking BPH medication
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BRCA-1
- ONCOGENE (autosomal dominant transmission)
- Indicates increased genetic susceptibility for breast cancer
- More common than BRCA 2
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BRCA-2
- ONCOGENE (autosomal dominant transmission)
- Indicates increased genetic susceptibility for breast cancer
- Also confers increased risk of developing ovarian cancer
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Estrogen Receptor (ER) Assay
- TISSUE RECEPTOR (test performed on tissue sample)
- Indicates that breast cancer is likely to respond to hormonal therapy (Tamoxifen, estrogens, androgens, oophorectomy, etc.)
- Good prognostic indicator
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Progesterone Receptor (PR) Assay
- TISSUE RECEPTOR (test performed on tissue sample)
- Indicates that breast cancer is likely to respond to hormonal therapy
- Good prognostic indicator
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HER 2/neu
- ANTIGEN (test performed in breast cancer tissue)
- Increased HER 2 protein levels associated w/more aggressive breast cancers
- Can serve as target for trastuzumab (Herceptin)
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CA 15-3
- ANTIGEN
- Elevated in 70-80% of patients w/metastatic breast cancer
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CA 27.29
- ANTIGEN
- Used for monitoring response to tx in metastatic breast cancer
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Philadelphia Chromosome
- ONCOGENE
- Most often elevated in Chronic Myelogenous Leukemia (CML); Can also be high in ALL or AML
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