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) Tumor Markers 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 testise.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