Tumour markers are substances released by cancer cells or produced by the body in response to cancer that can help detect and monitor cancer. They include enzymes, hormones, and antigens. Some common tumour markers are PSA for prostate cancer, CA125 for ovarian cancer, and CEA for colorectal cancer. While elevated levels can indicate cancer, tumour markers can also be increased in some non-cancerous conditions. Researchers are studying tumour markers to improve cancer detection, diagnosis, treatment evaluation and monitoring for recurrence.

1. Tumour Markers
Presented By-
Himanshu Upadhyay

2. Tumour Markers
• Tumour markers are oncoproteins or mutated forms of these
proteins that can indicate the presence of a tumour.
• Tumour Markers are substances either released by cancer
cells into the blood or urine or substances created by the
body in response to cancer cells.
• Tumour markers are used to evaluate how well a patient has
responded to treatment and to check for tumour recurrence.
• Research is currently being conducted on the role of tumour
markers in detection, diagnosis and treatment of cancers.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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3. • Tumour markers are used for screening of cancer or
monitoring the deseases.
• The first tumour marker reported was BENCE JONES PROTEIN
in multiple myeloma in 1847.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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4. Classification
Tumour Markers can be can be:
• Enzymes
• Hormones
• Antigen
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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5. Enzymes
• Alkaline phosphatase(ALP)- Liver Cancer
• Creatine Kinase- (CK1) – Brain, Prostate Gland, GI tract, Lung
• Lactate dehydrogenase (LDH)- Liver, Acute Leukaemia,
Breast, colon, Lung
• Prostatic acid phosphatase (PAP)- Prostatic,Bone
metastates , Multiple Myeloma
• 5-Nucleotidase-Liver
• Neuron Specific enolase- Pancreatic endocrine tumour,
Neuroblastoma, Associated with small lung cancer
• Alcohol dehydrogenase- LiverHimanshu Upadhyay (MSc. Clinical
Biochemist.)
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6. Hormones
• ACTH - Lung , Cushing’s syndrome
• Calcitonin- Medullary thyroid
• hCG- Embryonal, testicular choriocarcinoma
• Prolactin- Pituitary Adenoma
• Human Placental lactogen-Gonads, Lung, Breast
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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7. Cancer Antigens
• CA 15-3 – Breast Cancer
• CA 19-9 – Gastrointestinal tumours.
• CA-125 – Ovarian Cancers
• PSA – Prostate cancers,
• Alpha-fetoprotein – Hepatocellular and Germ cell Carcinoma
• CA 72-4 – Carcinomas of Gastrointestinal Tract & ovary
• CA 242 – Pancreatic and Colorectal cancer
• CA 50 – Pancreatic and Colorectal carcinoma
• Cyfra 21 – Lung
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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8. Characteristics
An ideal tumour marker should having
following:
• Highly Sensitive
• Highly Specific
• Able to differentiate between Neoplastic &
Non-Neoplastic diseases.
• Its level should be preceding the neoplastic
process.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
8

9. Prostatic-Specific Antigen
• Prostate- Specific Antigen(PSA) is always present in
low concentration in the blood of adult males.
• An elevated PSA level in the blood may indicate
prostate cancer, but other conditions such as benign
prostatic hyperplasia (BPH) and prostatitis can also
raise PSA levels.
• PSA levels are used to evaluate how a patient has
responded to treatment and to check for tumor
recurrence.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
9

10. Prostatic Acid Phosphatase (PAP)
• Prostatic acid phosphatase (PAP) originates in the
prostate and is normally present in small amounts in
the blood.
• In addition to prostate cancer, elevated levels of PAP
may indicate testicular cancer ,leukemia, and non -
Hodgkin's lymphoma, as well as some noncancerous
conditions.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
10

11. CA 125
• Ovarian cancer is the most common cause of elevated
CA 125.
• Cancer of uterus, cervix, pancreas, liver, colon, breast,
lung, and digestive tract can also raise CA 125 levels.
• Several noncancerous conditions can also elevate CA
125. CA 125 is mainly used to monitor the treatment of
ovarian cancer.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
11

12. Carcinoembryonic Antigen (CEA)
• Carcinoembryonic antigen (CEA) is normally
found in small amounts in the blood.
• Colorectal cancer is the most common cancer
that raises this tumor marker.
• Several other cancers can also raise levels of
carcinoembryonic antigen.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
12

13. Alpha-Fetoprotein (AFP)
• Alpha-fetoprotein (AFP) is normally elevated in
pregnant women since it is produced by the foetus.
• However, AFP is not usually found in the blood of
adults.
• In men, and in women who are not pregnant, an
elevated level of AFP may indicate liver cancer Or
cancer of ovary or testicle.
• Non-cancerous conditions may also cause elevated
AFP levels.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
13

14. Human Chorionic Gonadotropin
(HCG)
• Human chorionic gondado-tropin (HCG) is
another substance that appears normally in
pregnancy and is produced by the placenta.
• If pregnancy is ruled out, HCG may indicate
cancer in testis, ovary, liver, stomach,
pancreas, and lung.
• Marijuana use can also raise HCG levels.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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15. CA 19-9
• The CA 19-9 marker is associated with cancers in the
colon, stomach, and bile duct.
• Elevated levels of CA 19-9 may indicate advanced
cancer in the pancreas.
• It is also associated with noncancerous conditions,
including gallstones, pancreatitis, cirrhosis of the
liver, and cholecystitis.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
15

16. CA 15-3
• The CA 15-3 marker is most useful in evaluating the
effect of treatment for women with advanced breast
cancer.
• Elevated levels of CA 15-3 are also associated with
cancers of the ovary, lung, and prostate.
• Noncancerous conditions such as benign breast or
ovarian disease, endometriosis, pelvic inflammatory
disease, and hepatitis may also elevate CA 15-3.
• Pregnancy and lactation also can raise CA 15-3
levels.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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17. CA 27-29
• The CA 27-29 marker, like CA 15-3, is used to follow
the course of treatment in women with advanced
breast cancer.
• Cancer of colon, stomach, kidney, lung, ovary,
pancreas, uterus, and liver may also raise CA 27-29
levels.
• Noncancerous conditions associated with this
substance are first trimester pregnancy,
endometriosis, ovarian cysts, benign breast disease,
kidney disease, and liver disease.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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18. Lactate Dehydrogenase
(LDH)
• LDH is a protein that normally appears throughout
the body in small amounts.
• Many cancers can raise LDH levels, so it is not useful
in identifying a specific kind of cancer.
• Measuring LDH levels can be helpful in monitoring
treatment for cancer.
• Noncancerous conditions that can raise LDH levels
include heart failure, hypothyroidism, anemia, and
lung or liver disease.
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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19. Clinical Application
• Screening for Cancer
• Diagnosing Cancer
• Evaluating cancer prognosis
• Prediction of therapeutic response
• Tumour Staging
• Detecting tumour recurrence
• Localising tumour & directing radiotherapeutic
agents
• Monitoring effectiveness of cancer therapy
Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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20. Himanshu Upadhyay (MSc. Clinical
Biochemist.)
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