about the tumor marker on the cancer progression and diagnosis

1. Cancer Biochemistry

2. Tumour marker
• Any substance that can be related to the
presence or progress of a tumour.
• Hormones: human gonadotrophin (HCG)
secreted by choriocarcinoma
• Enzymes: prostate specific antigen (PSA) in
prostate carcinoma
• Tumour antigens: carcinoembryonic antigen
(CEA) in colorectal carcinoma

5. The use of tumour markers
Monitoring treatment
• Surgery, chemotherapy, radiotherapy
Assessing follow-up
• To monitor the marker long after the levels have
appeared to stabilized
Diagnosis
• Detection in blood, biopsy

6. Prognosis
• To be of value in prognosis, the
concentration of the tumour marker in
plasma should be correlate with tumour
mass.
• Eg: HCG correlates well with the tumour
mass in choriocarcinoma
• HCG and AFP correlate with the tumour
mass in testicular teratoma
• Paraproteins correlate with the tumour
mass in multiple myeloma.

7. Screening for the presence of disease
• Specific high-risk population
• Eg: hormone calcitonin, which is
increased in all patients with medullary
carcinoma of thyroid, may be used to
screen close relatives.

8. The important tumour markers:
• Alkaline phosphatase (ALP)
• Lactate dehydrogenase (LDH)
• Prostatic acid phosphatase (PAP)
• Prostate specific antigen (PSA)
• Human chorionic gonadotropin (HCG)
• Alpha-fetoprotein (AFP)
• Carcino-embryonic antigen (CEA)

9. • CA-15 : marker for breast carcinomas
• CA-125 : marker for ovarian and
endometrial carcinoma
• Calcitonin (secreted by cells of thyroid
gland. Increased in medullary tumour of
thyroid gland)
*carcinoma: cancer arising from epithelial
tissue.
sarcoma: cancer from connective tissue

10. • ALP
- Primary or secondary liver cancer
- Secondary bone cancer
- Lung cancer
- Cancer of GIT and ovary
- Hodgkin’s disease

11. • PAP
-malignant conditions: cancer of prostate,
multiple myeloma, osteogenic sarcoma.
-benign conditions: prostatic hypertrophy
(BPH) or enlarged prostate, osteoporosis
and hyperparathyroidism.
• PSA
-superior marker for prostatic cancer.

12. • Human Chorionic Gonadotropin (HCG)
-placental hormon. Synthesized by
syncytiotrophoblastic cells of placental
villi.
-choriocarcinoma. About 50% of cases of
choriocarcinoma follow hydatidiform
mole pregnancy and HCG is used to
screen these women.
-ideal tumour marker for diagnosing and
monitoring gestational trophoblastic
tumours and germ cell tumours of testes
and ovary.

13. • Alpha-Feto Protein (AFP)
-like CEA, AFP is another oncofetal antigen.
AFT is synthesized in liver, yolk sac and GI
tract in fetal life and released into serum
of fetus.
-AFP is the more specific and ideal tumour
marker for primary carcinoma of the liver
(hepatocellular carcinoma)
-serum AFP and HCG are best available
tumour markers for germ cell type of
tumours.

14. • Cancer antigen 125 (CA-125)
-used for screening and diagnosis of ovarian
carcinoma
-not specific for ovarian carcinoma
• CA 15-3 & CA-27.29
- useful as tumour marker in breast carcinoma
• CA 19-9
-useful as tumour marker in pancreatic cancer
and biliary tract cancers.

15. Hormones
• produced by many tumors
• natural product or represent abnormal
synthesis
• eg: insulin by islet cell tumor, calcitonin by
medullary thyroid carcinoma, catecholamines
by pheochromocytoma
• ectopic hormones - ACTH and ADH by lung
cancer