Tumour Markers Flashcards

1
Q

What is sensitivity?

A

Ability to detect those with disease

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2
Q

What is specificity?

A

Ability to detect those without disease

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3
Q

What are the classes of tumour markers?

A
Cell-surface glycoproteins 
Oncofetal proteins 
Hormones
Enzymes 
Immunoglobulins 
Nucleic acids
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4
Q

What are the cell surface glycoproteins?

A

Carcino-embryonic antigen (CEA)
CA125
CA19.9

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5
Q

What are the oncofetal proteins?

A

hCG

A-feto-protein (aFP)

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6
Q

What enzymes are tumour markers?

A
Acid phosphatase
Alkaline phosphatase
Lactate dehydrogenase
Neurone specific enolase
Intermediate metabolites
5-hydroxyindoleacetic acid
Vanillyl mandelic acid
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7
Q

What hormones are tumour markers?

A

Thyroglobulin,
Antidiuretic hormone,
Adrenocorticotrophic hormone

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8
Q

What immunoglobulins are tumour markers?

A

Bence Jones Protein

Light Chains

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9
Q

How are nucleic acids used as tumour markers?

A
RNA + DNA detected 
Tumour specific (eg Philadelphia chromosome) or tissue specific (eg detection of tyrosinase expression in blood)
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10
Q

When can tumour markers be used for screening?

A

In high risk groups eg use of aFP to detect hepatocellular carcinoma in pts with hepatitis

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11
Q

What conditions cause a raise in CEA?

A

Colorectal!!

Pancreatic, gastric, breast, lung cancer
Smoking, IBS, hepatitis, pancreatitis, gastritis

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12
Q

When is CA125 raised?

A

Endometriosis, pregnancy, menstruation + ovarian cancer

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13
Q

What tumour markers are diagnostic in young males with widespread mets?

A

Serum LDH, aFP, BhCG

To diagnose chemo sensitive germ cell tumours

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14
Q

What does an aFP level >500 indicate?

A

Hepatocellular carcinoma or germ cell tumours (non-seminomatous testicular cancer)

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15
Q

How can you measure prognosis in testicular cancer?

A

Concentrations of hCG or aFP

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16
Q

How can you monitor response to chemo for germ cell tumours?

A

Concentrations of hCG + aFP

17
Q

What is aFP?

A

Glycoprotein produced in normal fetal yolk sac, liver + intestines
Undetectable in normal individuals after 1 y/o

18
Q

When is aFP raised?

A

Hepatitis, hepatocellular carcinoma, cancers containing yolk sacs (teratomas)
High levels = poor prognosis

19
Q

When are immunoglobulins used as tumour markers?

A

Measure of paraproteinaemias (myeloma + Waldenstrom’s macroglobulinaemia)
Non-Hodgkins Lymphoma

20
Q

Where is the Bence Jones protein found + what does it indicate?

A

Measured in urine

Occurs in myeloma

21
Q

What cancers are CA19.9 + CA15.3 linked to?

A
  1. 9 = pancreatic

15. 3 = breast

22
Q

What tumours cause a raise in Bombesin?

A

SCLC
Gastric
Neuroblastoma