Updated: 2/13/2018

Tumor Markers

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Topic
Overview
  • Proteins released by neoplasm into circulation
  • Tumor markers should be used to
    • confirm diagnosis
    • monitor therapeutic response
    • monitor tumor recurrence
    • NOT as a means to diagnose cancer in absence of physical examination of the tissue (e.g. biopsy)
 
Reproductive Cancer Markers Normal Function Description
PSA (Prostate-specific antigen) Liquefaction of semen
  • Prostate carcinoma
    • also released with BPH and prostatitis
    • increase in bound PSA (as compared to free PSA) is suggestive of cancer
Prostatic acid phosphatase  
  • Prostate carcinoma
α-fetoprotein (AFP)
Fetal albumin
  • Hepatocellular carcinomas
  • Nonseminomatous germ cell tumors of the testis
    • e.g. yolk sac tumor
β-hCG Normally released by placenta as a corpus luteum trophic hormone
  • Hydatidiform moles
  • Choriocarcinomas
  • Gestational trophoblastic tumors
CA-125 Released by peritoneum with irritation (can be elevated in endometriosis)
  • Ovarian 
  • Epithelial tumors


Miscellaneous Cancer Markers       Description
TRAP (Tartrate-resistant acid phosphatase)
  • Hairy cell leukemia 
CA-19-9
  • Pancreatic adenocarcinoma
Chromogranin
  • Neuroendocrine tumors
Calcitonin
  • Medullary carcinoma of the thyroid
Multicancer Markers       Description
S-100
  • Melanoma 
  • Neural tumors
  • Astrocytomas
Alkaline phosphatase
  • Marker of bone formation
    • osteoblastic metastases to bone (e.g. prostate)
    • Paget's disease of bone
  • Also released when bile ducts are damaged
    • obstructive biliary disease
Bombesin
  • Neuroblastoma
  • Lung cancer
  • Gastric cancer
CEA
  • Colorectal cancer
  • Pancreatic cancer
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(M1.ON.14.98) A 57-year-old female presents to general gynecology clinic for evaluation of a pelvic mass. The mass was detected on a routine visit to her primary care doctor during abdominal palpation. In the office, she receives a transvaginal ultrasound, which reveals a mass measuring 11 cm in diameter. In the evaluation of this mass, elevation of which tumor marker would be suggestive of an ovarian cancer? Tested Concept

QID: 105268
1

S-100

0%

(0/15)

2

CA-125

87%

(13/15)

3

Beta-hCG

0%

(0/15)

4

Alpha fetoprotein

7%

(1/15)

5

CA-19-9

7%

(1/15)

M 2 D

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