This document discusses the laboratory diagnosis of cancer through various methods such as histological examination of tissue samples, cytological examination of cell samples, immunohistochemistry, serum tumor markers, and electron microscopy. It provides examples of commonly used tumor markers like CEA, AFP, HCG, PSA and CA-125 that can aid in the diagnosis, monitoring, and detection of cancer recurrence of certain cancer types like colon, liver, testicular, prostate and ovarian cancers. The prognosis of cancer depends on factors like the growth rate and characteristics of the tumor as well as the patient's overall health status.

1. NEOPLASIA
Laboratory Diagnosis
of Cancer
Dr. Roopam Jain
Professor & Head, PATHOLOGY

2. Laboratory Diagnosis
of Cancer

3. Laboratory Diagnosis of Cancer
 1) HISTOLOGICAL METHODS – Paraffin-embedding
technique, Frozen section
 2) CYTOLOGICAL METHODS – Exfoliative cytology,
FNAC; Bone marrow aspiration
 3) HISTOCHEMISTRY & CYTOCHEMISTRY
 4) IMMUNOHISTOCHEMISTRY
 5) ELECTRON MICROSCOPY
 6) SERUM TUMOR MARKERS

4. Tumor markers
 Tumor markers sometimes diagnostic or prognostic
 Can be helpful in monitoring effectiveness of
therapy or in detecting relapses/recurrences

5. Tumor Markers
 Tumor markers are biochemical indicators of
the presence of a tumor
 Tumor markers include: cell surface antigens,
cytoplasmic proteins, enzymes and hormones
 Example: Carcinoembryonic antigen (CEA) is
found in carcinomas of colon, pancreas, lung,
stomach and breast

6. Tumor Markers
 CEA assays lack both specificity and the sensitivity
required for the detection of early cancers, but good to
know relapse or as follow up procedure..
 Alpha-fetoprotein (AFP) is associated with liver cell
cancer & nonseminomatous germ cell tumors of the
testis
 AFP can be seen in non-neoplastic conditions such as
cirrhosis and hepatitis

7. TUMOR MARKERS
(Hormones)
MARKERS
Human chorionic
gonadotropin
Calcitonin
CANCERS
Trophoblastic tumors; Non-
seminomatous testicular
tumors
Medullary carcinoma of
thyroid

8. TUMOR MARKERS
(Hormones)
MARKERS
Catecholamine and metabolites
Ectopic hormones production
CANCERS
Neuroblastoma,
Pheochromocytoma and
related tumors
Tumors of the Paraneoplastic
Syndrome

9. TUMOR MARKERS
(Oncofetal Antigens)
MARKERS
Alpha-fetoprotein
Carcinoembryonic antigen
CANCERS
Liver cell cancer; Non-
Seminomatous germ cell
tumors of testis
Carcinomas of colon, pancreas,
lung, stomach & breast

10. TUMOR MARKERS
(Isoenzymes)
MARKERS
Prostatic acid phosphatase
(PAP)
Neuron-specific antigen (NSE)
CANCERS
Prostate cancer
Small cell cancer of lung,
Neuroblastoma

11. TUMOR MARKERS
(Isoenzymes)
MARKERS
Lactic dehydrogenase (LDH)
CANCERS
Lymphoma, Ewings sarcoma

12. TUMOR MARKERS
(Specific Proteins)
MARKERS
Immunoglobulins
Prostate-specific antigen (PSA)
CANCERS
Multiple myeloma and other
Gammopathies
Prostate cancer

13. TUMOR MARKERS
(Mucins & Other Glycoproteins)
MARKERS
CA-125
CA-19-9
CA-15-3
CANCERS
Ovarian cancer
Colon, pancreatic cancer
Breast cancer

14. Summary
The prognosis of a patient with any type of neoplasm
depends on a number of factors including:
 the rate of growth of the tumor,
 the size of the tumor,
 the tumor site,
 the cell type and
 degree of differentiation,
 the presence of metastasis,
 responsiveness to therapy,
 and the general health of the patient.