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Characteristics of Ideal Tumor Marker
1. TM should be present in or produced by tumor itself.
2. TM should not be present in healthy tissues.
3. Plasma level of TM should be at a minimum level in
healthy subjects and benign lesions.
4. TM should be specific for a tissue
5. Half life of a tumor marker should not be very long
6. TM levels correlates with the tumour stage, tumour
mass, and regression (during treatment or
recurrence)
7. TM should be present in plasma at a detectable level,
even when tumor size is very small
CLASSIFICATION OF TUMOR MARKERS
ACCORDING TO THE MOLECULE.
1. Enzymes (PSA, ALP)
2. Hormones (hCG, inhibin)
3. Oncofetal (AFP, CEA)
4. Glycoproteins/charbohydrates (CA 125, CA
15-3)
5. Proteins (immunoglobulin, thyroglobulin)
I.ENZYMES AS TUMOR MARKERS.
• Prostate Specific
Antigen(PSA)
• Produced only in the
epithelial cells of the acini
and ducts of the prostate
gland
• Functionally regulates
seminal fluid viscosity
Detection of total PSA has been
used in screening for and in
monitoring of prostate
cancer
it’s a tumor marker for prostste
cancer.
• ALKALINE PHOSPHATASE
(ALP)
• ALP is mainly present in liver,
biliary tract, bone and
placenta.
• Increased ALP can be seen in
• liver cancer
• Cancer of biliary tract
• Metastatic cancer with bone
or liver involvement
• Testicular seminomas.
II. HORMONES AS TUMOR MARKERS.
 HUMAN CHORIONIC
GONADOTROPIN(HCG).
• hCG is secreted by trophoblasts in the
placenta to maintain the corpus luteum
during pregnancy.
• hCG is elevated in
– trophoblastic tumors
– choriocarcinoma
– germ cell tumors of the ovary and testis.
• hCG has several clinical applications as a
tumor marker.
– it is a prognostic indicator for ovarian
cancer
– a diagnostic marker for classification of
testicular cancer
– the most useful marker for detection of
gestational trophoblastic diseases
(GTDS)
– Pregnancy test
• INHIBIN.
• Inhibin is a produced by
granulosa cells of the
ovary and sertoli cells of
the testes.
• Certain sex cord-stromal
tumors can produce
inhibin.
• Inhibin is a peptide
hormone produced by
ovarian granulosa cells.
• This is the tumor marker
for mucinous epithelial
ovarian carcinomas.
III. ONCOFETAL ANTIGENS AS TUMOR
MARKERS.
 A-FETOPROTEIN(AFP)
Synthesized by the yolk SAC, the fetal
liver and gut and is major plasma
protein.
In adults the normal conc is <10 g/L.
Increased plasma conc of protein are
seen in normal pregnancy.
It’s a tumor markerfor liver cell
cancer.
Also used in diasgnosis of neural
tube defects, hepatocellular
carcinomas (HCC) and
tesotherticular teratomas and
other germ cell carcinoma.
 CARCINOEMBRYONIC ANTIGEN(CEA)
tumor marker for colorectal
cancer, produced by normal
fetal gut cells and colorectal
cancer cells in adult.
also frequently elevated in lung,
breast, and gastrointestinal
tumors
but also high levels of CEA (>10
ng/mL) are associated with
non malignant conditions like
liver disease, pancreatitis
and inflamatory bowel
disease.
therefore CEA is not used for
screening, since its not
specific to colorectal cancer.
IV. Glycoproteins
 CANCER ANTIGEN 125(CA 125)
its a glycoprotein Produced by
epithelial cells lining female
reproductive tract including
ovarian tissue.
it is also elevated in patients with
– endometriosis
– during the first trimester of
pregnancy
– during menstruation.
A high level (> 95 U/mL) of CA-
125 has a 90% positive
predictive value for ovarian
cancer.
A marker for ovarian cancer.
 CANCER ANTGEN 15-3 (CA
15-3)
• Is a glycoprotein
Produced by certain
breast cancer cells. Its
shed in bloodstream
hence detected in
serum.
• A marker for breast
carcinoma.
• It may also be present in
pancreatic, Lung, Ovarian,
Colorectal and liver cancer
and in some breast benign
V. PROTEIN AS TUMOR MARKER.
 THYROGLOBULIN.
• Synthesized by thyroid cells
and stored within thyroid
gland as the precursor to T3
& T4.
• In thyroid cancer, both
normal& cancerous thyroid
cells produce thyroglobulin,
hence elevated levels in
blood.
• Is a useful marker for
detection of differentiated
thyroid cancer.
 IMMUNOGLOBULIN.
• Bence-Jones protein is
produced by abnormal
plasma cells in the bone
marrow.
• Bence-Jones protein is a
free monoclonal
immunoglobulin light chain
in the urine and its reliable
marker for multiple
myeloma.
TUMOR MARKERS.-1.pptx by Aikoman radiology scientist at Catholic University of health and allied sciences Mwanza.
TUMOR MARKERS.-1.pptx by Aikoman radiology scientist at Catholic University of health and allied sciences Mwanza.
TUMOR MARKERS.-1.pptx by Aikoman radiology scientist at Catholic University of health and allied sciences Mwanza.

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TUMOR MARKERS.-1.pptx by Aikoman radiology scientist at Catholic University of health and allied sciences Mwanza.

  • 1.
  • 2.
  • 3. Characteristics of Ideal Tumor Marker 1. TM should be present in or produced by tumor itself. 2. TM should not be present in healthy tissues. 3. Plasma level of TM should be at a minimum level in healthy subjects and benign lesions. 4. TM should be specific for a tissue 5. Half life of a tumor marker should not be very long 6. TM levels correlates with the tumour stage, tumour mass, and regression (during treatment or recurrence) 7. TM should be present in plasma at a detectable level, even when tumor size is very small
  • 4.
  • 5.
  • 6. CLASSIFICATION OF TUMOR MARKERS ACCORDING TO THE MOLECULE. 1. Enzymes (PSA, ALP) 2. Hormones (hCG, inhibin) 3. Oncofetal (AFP, CEA) 4. Glycoproteins/charbohydrates (CA 125, CA 15-3) 5. Proteins (immunoglobulin, thyroglobulin)
  • 7. I.ENZYMES AS TUMOR MARKERS. • Prostate Specific Antigen(PSA) • Produced only in the epithelial cells of the acini and ducts of the prostate gland • Functionally regulates seminal fluid viscosity Detection of total PSA has been used in screening for and in monitoring of prostate cancer it’s a tumor marker for prostste cancer. • ALKALINE PHOSPHATASE (ALP) • ALP is mainly present in liver, biliary tract, bone and placenta. • Increased ALP can be seen in • liver cancer • Cancer of biliary tract • Metastatic cancer with bone or liver involvement • Testicular seminomas.
  • 8. II. HORMONES AS TUMOR MARKERS.  HUMAN CHORIONIC GONADOTROPIN(HCG). • hCG is secreted by trophoblasts in the placenta to maintain the corpus luteum during pregnancy. • hCG is elevated in – trophoblastic tumors – choriocarcinoma – germ cell tumors of the ovary and testis. • hCG has several clinical applications as a tumor marker. – it is a prognostic indicator for ovarian cancer – a diagnostic marker for classification of testicular cancer – the most useful marker for detection of gestational trophoblastic diseases (GTDS) – Pregnancy test • INHIBIN. • Inhibin is a produced by granulosa cells of the ovary and sertoli cells of the testes. • Certain sex cord-stromal tumors can produce inhibin. • Inhibin is a peptide hormone produced by ovarian granulosa cells. • This is the tumor marker for mucinous epithelial ovarian carcinomas.
  • 9. III. ONCOFETAL ANTIGENS AS TUMOR MARKERS.  A-FETOPROTEIN(AFP) Synthesized by the yolk SAC, the fetal liver and gut and is major plasma protein. In adults the normal conc is <10 g/L. Increased plasma conc of protein are seen in normal pregnancy. It’s a tumor markerfor liver cell cancer. Also used in diasgnosis of neural tube defects, hepatocellular carcinomas (HCC) and tesotherticular teratomas and other germ cell carcinoma.  CARCINOEMBRYONIC ANTIGEN(CEA) tumor marker for colorectal cancer, produced by normal fetal gut cells and colorectal cancer cells in adult. also frequently elevated in lung, breast, and gastrointestinal tumors but also high levels of CEA (>10 ng/mL) are associated with non malignant conditions like liver disease, pancreatitis and inflamatory bowel disease. therefore CEA is not used for screening, since its not specific to colorectal cancer.
  • 10. IV. Glycoproteins  CANCER ANTIGEN 125(CA 125) its a glycoprotein Produced by epithelial cells lining female reproductive tract including ovarian tissue. it is also elevated in patients with – endometriosis – during the first trimester of pregnancy – during menstruation. A high level (> 95 U/mL) of CA- 125 has a 90% positive predictive value for ovarian cancer. A marker for ovarian cancer.  CANCER ANTGEN 15-3 (CA 15-3) • Is a glycoprotein Produced by certain breast cancer cells. Its shed in bloodstream hence detected in serum. • A marker for breast carcinoma. • It may also be present in pancreatic, Lung, Ovarian, Colorectal and liver cancer and in some breast benign
  • 11. V. PROTEIN AS TUMOR MARKER.  THYROGLOBULIN. • Synthesized by thyroid cells and stored within thyroid gland as the precursor to T3 & T4. • In thyroid cancer, both normal& cancerous thyroid cells produce thyroglobulin, hence elevated levels in blood. • Is a useful marker for detection of differentiated thyroid cancer.  IMMUNOGLOBULIN. • Bence-Jones protein is produced by abnormal plasma cells in the bone marrow. • Bence-Jones protein is a free monoclonal immunoglobulin light chain in the urine and its reliable marker for multiple myeloma.