Tumor markers are substances, such as proteins, biochemicals, hormones or enzymes, produced by tumor cells or by the body in response to tumor cells. As tumor cells multiply, cancer spreads, and tissue is damaged, these substances increase and leak into the bloodstream. Tumor marker levels in blood help physicians evaluate people for certain types of cancer

1. TUMOUR MARKERS

2. Tumor markers are substances, such as proteins,
biochemicals, hormones or enzymes, produced by tumor
cells or by the body in response to tumor cells. As tumor
cells multiply, cancer spreads, and tissue is damaged,
these substances increase and leak into the bloodstream.
Tumor marker levels in blood help physicians evaluate
people for certain types of cancer

7. Alpha Fetoprotein
(AFP)

8. Alpha-fetoprotein (AFP) is a glycoprotein that is
produced in early fetal life by the liver and by a variety
of tumors including hepatocellular carcinoma,
hepatoblastoma, and nonseminomatous germ cell
tumors of the ovary and testis (eg, yolk sac and
embryonal carcinoma).

9. Most studies report elevated AFP concentrations in
approximately 70% of patients with hepatocellular
carcinoma. Elevated AFP concentrations are found in
50% to 70% of patients with nonseminomatous testicular
tumors
The biological half-life of AFP is approximately 5 days.

10. AFP is elevated during pregnancy. Persistence of AFP
in the mother following birth is a rare hereditary
condition.
Neonates have markedly elevated AFP levels (>100,000
ng/mL) that rapidly fall to below 100 ng/mL by 150 days
and gradually return to normal over their first year

11. Reference values are for nonpregnant subjects only - <8.4
ng/mL

12. Concentrations of AFP above the reference range also
have been found in the serum of patients with benign
liver disease (eg, viral hepatitis, cirrhosis),
gastrointestinal tract tumors, and along with
carcinoembryonic antigen, in ataxia telangiectasia
(childhood disease. It affects the brain - uncoordinated movements and
enlarged blood vessels).

13. Interpretation
Alpha-fetoprotein (AFP) levels may be elevated in
association with a variety of malignancies or benign
diseases.
Failure of the AFP value to return to normal by
approximately 1 month after surgery suggests the
presence of residual tumor.
Elevation of AFP after disappearance of signs and
symptoms, tumor recurrence; however, tumors originally
producing AFP may recur without an increase in AFP.

14. Carcinoembryonic antigen
(CEA)

15. CEA is a protein found in the tissues of a
developing baby. CEA levels normally become very
low or disappear after birth. Healthy adults should
have very little or no CEA in their body.
A high level of CEA can be a sign of certain types
of cancers.

16. CEA is tested in blood.
The normal range is <2.5 ng/ml in an adult
non-smoker
<5.0 ng/ml in a smoker.

17. CEA is used to diagnosed with one of these
cancers:
● Bladder
● Breast
● Colon and/or rectal
● Lung
● Ovarian
● Pancreatic
● Stomach
● Thyroid

18. Grossly elevated carcinoembryonic antigen (CEA) concentrations (>20
ng/mL) in a patient with compatible symptoms are strongly suggestive of
the presence of cancer and also suggest metastasis.
Most healthy subjects (97%) have values < or =3.0 ng/mL.
After removal of a colorectal tumor, the serum CEA concentration should
return to normal by 6 weeks, unless there is residual tumor.
Increases in test values over time in a patient with a history of cancer
suggest tumor recurrence.
Interpretation

19. Human chorionic gonadotropin
(hCG)

20. HCG is a glycoprotein produced by the placenta to
maintain the corpus luteum (fertilization occurs) during
pregnancy.
HCG can be elevated in a number of other
malignancies, including cancers of the
liver, lung, pancreas and stomach.

21. hCG is also at a high level in patients with primary testes
insufficiency.
Beta Subunit HCG (human chorionic gonadotropin): A
serum test used as a tumor marker for testicular
carcinoma. Beta-HCG levels are never found in normal
men. When the presence of β-HCG is detected in serum it
always indicates a malignancy.

22. hCG is a very sensitive marker for early
choriocarcinoma and can detect tumors
weighing only 1 mg.

23. After delivery, miscarriage, or pregnancy termination,
human chorionic gonadotropin (hCG) falls with a half-life of
24 to 36 hours, until prepregnancy levels are reached. An
absent or significantly slower decline is seen in patients
with retained products of conception.
Interpretation

24. Serum hCG levels are elevated in approximately 40% to
50% of patients with nonseminomatous testicular cancer
and 20% to 40% of patients with seminoma. Markedly
elevated levels of hCG (>5,000 IU/L) are uncommon in
patients with pure seminoma and indicate the presence of
a mixed testicular cancer.

25. Ovarian germ cell tumors (approximately 10% of ovarian
tumors) display elevated hCG levels in 20% to 50% of
cases. Teratomas in children may overproduce hCG,
even when benign, resulting in precocious pseudopuberty.
Levels may be elevated to similar levels as seen in
testicular cancer.
Teratomas are tumours made up of tissues, such as hair, muscle and bone. They most often occur
in the ovaries in women and the testicles in men.
Affected boys have premature virilization and rapid growth, but they do not produce sperm.

26. Among nonreproductive tumors, hepatobiliary tumors
(hepatoblastomas, hepatocellular carcinomas, and
cholangiocarcinomas –bile duct) and neuroendocrine
tumors (eg, islet cell tumors and carcinoids) are those most
commonly associated with hCG production.

27. PRECAUTIONS
•There is not a good consensus in the medical community about the value of
most tumor or markers
•They lack specificity and accuracy
•False-positives can cause emotional distress and fear
•It is not yet determined if there is savings of life or money with testing
•Currently, much controversy surrounds the issue of mass screening for
cancer using tumor marker

28. In the future, the development of biochips will grow much faster than rest
of the diagnostic industry which will include DNA, RNA, and protein
chip. All the types of samples will be analyzed including tissues, cells,
and body fluids. Integrated diagnostic tools that combine these methods
with molecular imaging technique will be used. Finally, bioinformatics
will link to scientific data to clinical information to provide and better
more comprehensive care of the patient's health.
Future scope

29. Thank U !!!
magibio@gmail.com
+91 9486000227
Dr. V. MAGENDIRA MANI
Assistant Professor
Department of Biochemistry
Islamiah College (Autonomous), Vaniyambadi – 635751.