Tumour markers

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