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Tumor Markers
American cancer societyBritish Journal of Cancer
By B.Heidari
What are tumor markers?
substances that can be found in the body when cancer is present
Classic : protein in the blood in higher than normal
Some : in urine or other body fluid others are found in tumors and other tissue
Most tumor markers are proteins, but some newer markers are genes or other substances.
In one type of cancer-in many types of cancer
Sample : blood-urine-piece of the tumor Tumor markers alone are rarely enough
to show that cancer is present ! tumor markers -> patient’s history,
physical exam, other lab tests or imaging
How are tumor markers used?
1. Screening and early detection of cancer2. Diagnosing cancer3. Advanced cancer4. Determining prognosis for certain
cancers5. Seeing if certain treatments are likely to
work6. Seeing how well treatment is working7. Looking for recurrent cancer
Specific tumor markers
The tumor markers listed here are available to most doctors and have reliable scientific
information showing that they are useful.
CA 19-9 was first developed to detect colorectal colorectal
cancer most often used in : pancreatic cancer In very early disease the level is often normal,
so it’s not good as a screening test Still, it’s the best tumor marker for following
patients who have cancer of the pancreas. Normal blood levels below 37 U/mL elevated in cancer bladder – colorectal –
stomach - bile ducts non-cancerous conditionsthyroid disease,
rheumatoid arthritis, inflammatory bowel disease, and pancreatitis
CA 125 standard tumor marker used to follow epithelial ovarian
cancer Normal blood levels below 35 U/mL More than 90% of advanced ovarian cancer have high
levels. Levels are also elevated in about half of women whose
cancer has not spread outside of the ovary screening test
Trouble : miss many early cancers & problems other than ovarian cancer(uterine fibroids or endometriosis)
elevated in cancerlung, pancreatic, breast, liver, and colon, cancer in the past
ovarian cancer is arather rare diseaseincreased CA-125 level something other than ovarian cancer.
CEA (Carcinoembryonic antigen) CEA is not used to diagnose or screen for
colorectal cancer, but it’s the preferred tumor marker to help predict outlook.
Normal blood levels below 5.5 ng/mL standard marker :responding to treatment,
recurrency elevated in cancerlung, breast,melanoma,
lymphoma, thyroid, pancreas, liver, stomach, kidney, prostate, ovary, cervix, bladder
non-cancerous diseaseshepatitis,COPD, colitis, rheumatoid arthritis, and pancreatitis, healthy smokers
HER2 (or HER2/neu, erbB-2, or EGFR2) is a protein that tells some cancer cells to grow Elevate in breast cancer cells in about 1 out of
5 people with breast cancer elevated in cancerstomach, esophagus Sample:tissue HER2-positive:grow and spread faster than
other cancers -> respond to drugs that work against the HER2 receptor
All newly diagnosed breast cancers and advanced stomach cancers should be tested for HER2
P53
(BCC7; LFS1; TRP53 ) nuclear phosphoprotein functions as tumor
suppressor by inhibiting cell proliferation dominant role in cellular apoptosis P53 gene mutations : 50% of all types of
cancers Commonly :primary breast , colon,
ovarian, lung, and esophageal carcinomas
Ki-67
cancer antigen that is found in growing, dividing cells but is absent in the resting phase of cell growth
a good response to chemotherapy sample :tumor tissue high levels : aggressive tumor and
predict a poor prognosis , the risk of recurrence
elevated in cancerbreast, bladder, brain, colon, prostate
The End