tumour marker for medincine residents

8/12/2019 Tumour Marker for Medincine Residents

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Tumor markersPresent;

by

Dr. AndalibIsfahan Medical School


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cancer is a broad term used

to describe > 200 differentdiseases that affect 50

tissues.

Overview


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Biological substancessynthesized and released by

cancer cells themselves orproduced by normal cells inresponse to tumor.

Most tumor markers areproteins


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Tumor SpecificTransplantation Antigen(TSTA)

Tumor Specific Antigen(TSA)Viral antigens

proto oncogenes

Tumor antigens


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Tumor Associated Antigens (TAA)of certain cancerous tissue BUTlarge overlap

tissue differentiation antigens

gene products with increased expression

altered glycoproteins and glycolipids

Altered expression of gene products

Oncofetal antigens

Tumor antigens


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Screening of disease.

Diagnosis of symptomatic patients.

Staging of cancers.

Prognostic indicators.

Detect recurrence in Follow-Up of disease.

Monitoring response to therapy.

Tumor antigens could be used

for


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Tumor marker

First tumour marker

1938

Acid phosphatase for metastatic prostate


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Tumor markers Are biochemical substances which, as the name

suggest, are closely associated withcarcinogenesis

Are substances, such as proteins, biochemical,or enzymes, produced by tumor cells or by thebody cells in response to tumor cells

Are substances that can often be detected inhigher than normal in the blood, urine, or bodytissues of some patients with certain types ofcancer

Substances present in or produced by a tumoritself or produced by the host in response to atumor


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Tumor markers

Measurement of tumor markers: helpful

Tumor marker levels could elevated in

benign conditions Many tumor markers are not specific to a

particular type of cancer

In addition diagnosis :help physiciansmake a plan for appropriate therapy


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Tumor markers

Used to differentiate tumor from normal tissue

Determine presence of tumor based on quantity

in blood or secretions Higher quantity in cancer tissue, or in blood

from cancer patient, then in benign tumors ornormal individuals

Few tumor markers are specific for a single typeof tumor


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Tumor marker classification

Tumor antigens

Enzymes

Hormones

Oncogene products

Oncofetal

Receptors

Genetic markers


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Tumor antigens-Oncofetal

Oncofetal:produced during normalemberyogical development and by

neoplastic cells Defined by polyclonal or monoclonal

antibodies

CEA, AFP, HCG


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Tumor associated antigens

(Cancer antigen) CA 125

Ca 19-9

CA 15-3

CA 27-29

CA 50

CA 242


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ENZYMES

Neuron specific enolase(NSE)

Acid phosphatase

Lactic dehydrogenase


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Dunn et al.Nature Reviews Immunology

6, 836848 (November 2006) |

doi:10.1038/nri1961


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Hormones

* Human Chorionic Gonadotrophins (HCG)

are secreted in Choriocarcinoma,

Ovarian Cancer

* Thyroxin is secreted in thyroid

cancer


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Ideal marker

Specific: produced only by cells of aparticular malignancy and not by other

cancers, or benign conditions Sensitive: produced in all patient with

similar malignancy


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Specific organ tumor systems

Gastrointestinal tumors

CEA

AFP

CA19-9


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PSAProstate specificantigen


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PSA

In low concentration in the blood of all

adult males Is produced both normal and abnormal

prostate cells

Elevated PSA levels: in blood of men withbenign prostate condition

Prostatitis/benign hyperplasia/malignant


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PSA

PSA level:monitoring the effectiveness ofprostate cancer treatment

Checking recurrence after treatment


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PSAAs a screen for prostate

cancer or in the elevation ofor to follow up a person with

prostate disease


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CA 27-29

Breast cancer

Check for recurrence in woman previously

treated for stage 2 and stage 3 breast cancer Colon/stomach/kidney/lung/ovary/

pancreas/uterus/liver

Nan-cancerous: first trimesterpregnancy/endometritis/ovarian cysts/benignbreast disease/kidney disease/liver disease


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Title


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NSENeuron-specificenolase

Neuroblastoma


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NSE

Neuroblastoma/small cell lungcancer/wilms tumor/melanoma/cancers of

thyroid/kidney/testicule/pancreas Patient prognosis

Patient response to treatment


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CEACarcino-Emberyonic

Antigen


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CEA

Found on cell membrane

Easily released into fluids

Related to immunoglobolin super-family genes

Normally found in mucus secretions

of the stomach, small intestine


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CEA

Small amount in the blood of healthy people

Primary use of CEA: in monitoring colorectal

cancer Melanoma/lymphoma/breast/lung/pancreas/sto

mach/cervix/bladder/kidney/thyroid/liver/ovary

Nan-cancerous condition: inflammatory bowel

disease/pancreatitis/liver disease

Tobacco users


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CEA

lOW SPECIFICITY and lOW SENSITIVITY


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AFP

Alpha-fetoprotein


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AFP

First described oncofetal antigen

Normally: by a developing fetus

AFP level :elevated :liver cancer/germ cellcancer/ovary/testicule

Non-cancerous condition: benign livercondition /cirrohosis orhepatitis/pregnancy


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CA 19-9Cancerantigen 19-9


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CA 19-9

A carbohydrated antigen detected bymonoclonal antibodies

Pancreatic cancer Biliary tract cancer

Billary tract disease

pancreatitis


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TUMOR MARKER

Screening

Diagnosis

Prognosis

monitoring


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CA 125Cancerantigen125

ovarian cancer


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CA 125

Is produced by a variety of cells(ovariancancer)

Is used primarily in the management andtreatment of ovarian cancer

In woman with ovarian cancer:

chemotherapy


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CA125

Falling CA125 levels generally indicatesthat cancer is responding to treatment

Increasing CA125 levels during or aftertreatment: is not responding to therapy


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CA 125

To monitor for recurrence of ovariancancer

Uterus/cervix/pancease/liver/colon/breast/lung/digestive tract

Non-cancerous condition: elevated

CA125(endometriosis/pelvic inflammatorydisease/peritonitis/liver disease

Menstruation and pregnancy


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HCG

Is produced by placenta during pregnancy

For screen choriocarcinoma

Monitoring the treatment of trophoblasticdisease

Elevated HCG

level:testis/ovary/liver/stomach/pancreas/ lung/pregnancy/marijuana


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CA 15-3Cancer antigen 15-3

breast cancer


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CA 15-3

In following the course of treatment in womendiagnosis with breast cancer(advance)

Early stage breast cancer Ovary/lung/prostate

Non-cancerous condition: benign breast/ovariandisease /endometrisis/pelvic inflammatory

disease/hepatitis

Pregnancy


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Tumor marker

Screen and diagnose cancer

Predicting prognosis

Monitor treatment observation for cancer recurrence


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Realty

No marker to date satisfy these criteria


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Thank you

tumour marker for medincine residents

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