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Tumour markers

Authoring team

The most valuable application of tumour markers has been in the detection of recurrence of malignant disease following treatment. Examples include:

  • hormones:
    • calcitonin - medullary thyroid carcinoma
    • ACTH, ADH - small cell bronchial carcinoma

  • enzymes:
    • prostatic acid phosphatase - spread of prostatic carcinoma
    • bone alkaline phosphatase - primary and secondary osteoblastic tumours, for example, osteogenic sarcoma; significantly, not multiple myeloma
    • liver alkaline phosphatase - primary and secondary liver tumours; associated with localised intra-hepatic biliary obstruction. Other membrane bound enzymes may also increase - such as gamma glutamyl transferase
    • neurone specific enolase - small cell lung cancer; elevated in 70% of untreated patients

  • tumour antigens:
    • carcinoembryonic antigen - post-operative colorectal carcinoma; lacks the specifity or sensitivity to establish a diagnosis of cancer
    • alpha-feto protein - hepatocellular carcinoma, teratoma
    • prostate specific antigen - prostatic carcinoma

  • monoclonal antibodies raised to carbohydrate or glycoprotein antigenic determinants:
    • CA 125 - ovarian carcinoma
    • CA 15-3 - breast carcinoma
    • CA 19-9 - pancreatic, gastric, hepatobiliary carcinoma

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