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Clinical Chemistry Exam 1 Lecture 9
Tumor Markers
77
Chemistry
Undergraduate 3
01/31/2015

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Term
Cancer
Definition
Uncontrolled cellular growth in the form of tumors
Term
What is the second cause of death in the United States of America?
Definition
Cancer
Term
Highest Cancer Cases for Men Estimated in 2009
Definition
Prostate
Lung
Colorectal
Term
Highest Cancer Deaths for Men Estimated in 209
Definition
Lung
Prostate
Colorectal
Term
Highest Cancer Cases for Women Estimated in 2009
Definition
Breast
Lung
Colorectal
Term
Highest Cancer Deaths for Women Estimated in 2009
Definition
Lung
Breast
Colorectal
Term
Tumor Marker
Definition
A substance released by a tumor or released by a tissue affected by a tumor
Term
Are Tumor Markers generally useful for screening?
Definition
No
Term
Why are tumor markers generally not useful for screening?
Definition
May be = in presence of tumor
May be + in absence of tumor
Term
6 Major Clinical Value of Tumor Markers
Definition
Monitoring therapeutic response after diagnosis
Detecting cancer recurrence
Predicting patient prognosis
Screening
Confirmation of disease
Tumor Staging
Term
3 Basic types of tumor markers
Definition
Proteins
Tissue Receptors
DNA-based
Term
Tissue Receptors
Definition
Cell membrane proteins that bind to hormones
Term
When given the Protein Biomarker give the Cancer type:
AFP
Definition
Hepatocellular & germ cell
Term
When given the Protein Biomarker give the Cancer type:
CA-125
Definition
Ovarian
Term
When given the Protein Biomarker give the Cancer type:
HE4
Definition
Ovarian
Term
When given the Protein Biomarker give the Cancer type:
Tg
Definition
Thyroid
Term
When given the Protein Biomarker give the Cancer type:
PSA
Definition
Prostate
Term
When given the Protein Biomarker give the Cancer type:
CEA
Definition
Colon
Term
When given the Protein Biomarker give the Cancer type:
CA 19-9
Definition
Colon and Pancreatic
Term
When given the Protein Biomarker give the Cancer type:
CA 15-3/27-29
Definition
Breast
Term
When given the Protein Biomarker give the Cancer type:
HER2/neu
Definition
Breast
Term
HER-2-NEU
Definition
Oncogene overexpressed in 20% invasive breast cancers
Term
HER-2-NEU used to determine what?
Definition
Which drugs to use
Term
CA 15-3 is used to do what?
Definition
Monitor response to treatment, to watch for recurrence, and to watch for metastases
Term
What type of tumors are associated with Human Chorionic Gonadotrophin - Beta HCG
Definition
Hydatidiform mole
Choriocarcinoma
Testicular tumors
Ovarian tumors
Term
Use a combination of what for monitoring response to therapy/recurrence of testicular cancer?
Definition
AFP and HCG
Term
True or False:
Beta HCG is usually undetectable in normal adult serum
Definition
True
Term
Beta-2 Microglobulin
Definition
Protein on the surface of WBCs, especially lymphs
Term
Does Beta-2 Microglobulin have value in prognosis?
Definition
Yes
Term
What diseases are associated with Beta-2 Microglobulin?
Definition
Multiple Myeloma
Lymphomas
Term
What tests do you use to determine immunoglobulins?
Definition
Protein electrophoresis
IFE
Term
What diseases are associated with immunoglobulins?
Definition
Multiple Myeloma
Waldenstrom's
Term
Bladder Tumor-Associated Antigen (BTA): Test for in what sample?
Definition
Urine
Term
What is the Leading cause of Bladder Cancer?
Definition
Cigarette smoking
Term
You use BTA in conjuction with what else to detect recurrence of bladder disease?
Definition
Cystoscopy
Term
What are the following used to determine:
Estrogen and Progesterone Receptors
Definition
Response to hormone therapy
Term
What type of receptors are Estrogen and Progesterone Receptors?
Definition
Tissue Receptors
Term
What are the 9 FDA-Approved Protein Biomarkers?
Definition
AFP
CA 125
HE4
Tg
PSA
CEA
CA 19-9
CA 15-3
HER-2-NEU
Term
Alpha-Fetoprotein has the highest levels in the fetus and _____ amounts in adults
Definition
negligible
Term
What types of diseases are associated with Alpha-Fetoprotein (AFP)?
Definition
Testicular cancer
Hepatocellular carcinoma
Term
Where is Alpha-Fetoprotein used as a screen?
Definition
Only in countries where liver cancer occurs at a high rate
Term
CA 125 80% Positive
Definition
Ovarian Cancer
Term
CA 125 High levels post-surgery are associated with ______ prognosis
Definition
poorer
Term
CA 125 is also elevated with ________
Definition
endometriosis
Term
HE4 is the newest marker that is used to determine what?
Definition
Ovarian cancer recurrence
Term
Thyroglobulin should be ____ after resection
Definition
Low
Term
Thyroglobulin is associated with which organ?
Definition
Thyroid
Term
What disease is Thyroglobulin elevated in?
Definition
Grave's Disease
Term
PSA is what type of screen?
Definition
Prostate Cancer Screen
Term
Only ___ amounts of PSA in healthy men
Definition
trace
Term
Do levels of PSA increase or decrease with age?
Definition
Increase
Term
PSA plus what is the Best Screen?
Definition
DRE
Term
What % of PSA is bound to serum proteins
Definition
70-80%
Term
What % of PSA is free?
Definition
A Smaller Percentage
Term
Total PSA =
Definition
Bound + Free
Term
Free PSA % =
Definition
Free / Total PSA
Term
PSA is also elevated in what?
Definition
Benign Prostatic Hyperplasia (BPH)
Term
____% PSA indicates higher risk of cancer
Definition
<25
Term
What type of cancer is Carcinoembryonic Antigen (CEA) associated with?
Definition
Colon Cancer
Term
Other than Colon Cancer what other types of cancer is Carcinoembryonic Antigen (CEA) associated with?
Definition
Breast Cancer
Lung Cancer
Pancreatic Cancer
Rectal Cancer
Term
Is CEA very sensitive?
Definition
No, 35% of colorectal cancer patients have = CEAs
Term
Is CEA supposed to be used as a screen for colorectal cancer?
Definition
No
Term
True or False:
Cigarette smokers have higher levels of CEA than nonsmokers
Definition
True
Term
What disease is CEA increased in?
Definition
COPD
Term
What is CEA most frequently used for?
Definition
Cancer Management
Term
True or False:
CEA is the most frequently used tumor marker in cancer management
Definition
True
Term
What type of cancers is CA 19-9 associated with?
Definition
Pancreatic, Colon, and Bile Duct Cancers
Term
CA 19-9 is Elevated in about ____% of those with bile duct cancer
Definition
65
Term
True or False:
Non-cancerous causes of bile duct obstruction can cause very high CA 19-9 levels which fall when the blockage is cleared
Definition
True
Term
What is the leading type of cancer in women?
Definition
Breast Cancer
Term
What is the leading type of cancer in men?
Definition
Prostate Cancer
Term
What is the formula for a free PSA%?
Definition
>25% is Good
Term
What is the usefulness of calculating a fPSA%?
Definition
Differentiate Cancer from BPH
Term
What tissue markers are frequently used to determine the expected response to hormone treatment in a woman with breast cancer?
Definition
CA 15-3
HER-2-NEU
Term
What hormone marker is used to monitor the progression of both uterine cancer and testicular cancer?
Definition
Beta-HCG
Term
Name the marker used with multiple myeloma patients to establish initial prognosis
Definition
Beta-2 Microglobulin
Term
Name the marker used with multiple myeloma patients to monitor progression
Definition
Immunoglobulins
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