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Tumour markers

A tumour marker is anything present in or produced by cancer cells or other cells of the body in response to cancer or certain benign (noncancerous) conditions. These markers provide information about cancer, such as how aggressive it is, whether it can be treated with targeted therapy, or whether it responds to treatment.

Tumour markers have traditionally been proteins or other substances made by both normal and cancer cells but at higher amounts by cancer cells. These can be found in the blood, urine, stool, tumours, or other tissues or bodily fluids of some patients with cancer. Increasingly, however, genomic markers such as tumour gene mutations, patterns of tumour gene expression, and nongenetic changes in tumour DNA are being used as tumour markers.

Syndromic tumour marker index

Adeno/others

  • CA 72-4
  • CEA
  • TPA
  • ACTH
  • ADH
  • Ferritin
  • PTH
  • Calcitonin

 

Bile ducts

  • Ca 19-9
  • CA 125
  • CEA
  • CA 50

 

Bladder

  • Ca 19-9
  • CA 125
  • CEA
  • CA 50

 

Bronchia/Lungs

  • CEA
  • TPA
  • M2PK

 

Cervix

  • SCCA
  • Cyfra 21.1
  • CEA
  • TPA

 

Chorion

  • β-hCG

 

Colon

  • CEA
  • CA 19-9
  • CA 72-4
  • M2PK
  • Hemoglobin/Hb-Haptoglobin-complex
  • Septin 9

 

Endometrium/Uterus

  • SCCA
  • CEA
  • CA 125

 

Germinal

  • AFP
  • β-hCG

 

Hydatidiform Mole

  • β-hCG (up to 1 Mio. U/l, frequency 1:20,000)

Hypophysis

  • Prolactin (prolactinoma)
  • HGH (gigantism, acromegaly)
  • ACTH

 

Intestine

  • CEA
  • CA19-9
  • Serotonin
  • 5-HIAA

 

Liver

  • AFP
  • CA 19-9

 

Mamma

  • Cervix
  • SCCA
  • Cyfra 21.1
  • CEA
  • TPA

 

Mouth / Tongue

  • SCCA
  • CEA
  • TPA
  • CA 19-9

 

Oesophagus

  • SCCA
  • CEA
  • CA 19-9
  • CA 125
  • Cyfra 21.1

 

Ovary

  • CA 125
  • HE-4
  • ROMA-Index
  • CA 72-4
  • AFP
  • CEA
  • TPA
  • β-hCG
  • Testosterone

 

Paraneoplastic syndrome

  • ACTH
  • Cortisol
  • Calcitonin
  • Serotonin
  • 5-HIAA

 

Prostate

  • PSA
  • Free PSA
  • Prostate acidic phosphatase (PSP)
  • PCA3

Rectum

  • CEA
  • CA 19-9
  • CA 72-4
  • M2PK
  • Hemoglobin/Hb-Haptoglobin-complex
  • Septin 9

 

Stomach

  • Squamous epithelial. carcinoma
  • SCCA
  • CEA
  • Cyfra 21.1

 

Suprarenal (Cortex)

  • Cortisol
  • DHEA-S
  • Aldosterone
  • Testosterone

 

Suprarenal (Medulla)

  • Metanephrines
  • Catecholamines
  • VMS (pheochromocytoma)

 

Squamous epithelial. carcinoma

  • SCCA
  • CEA
  • Cyfra 21.1

 

Small-celled carcinoma

  • NSE
  • TPA
  • CEA

 

Testis

  • AFP
  • β-hCG
  • NSE
  • SCCA
  • M2PK

 

Thyroid

  • Thyroglobulin (hTG)
  • Calcitonin
  • CEA

 

Syndromic tumour marker index

Marker Disease Non-Malignant Increase
ACHT HVL, Lungs M.Addison, AGS
AFP Liver, germ cells Acute and chronic hepatitis, liver cirrhosis, pregnancy, children less than 1
Bence Jones Protein (BJP) Plasmocytoma
CA 125 Ovary, Bile ducts, gastrointestinal tracts, mamma, pleural mesothelioma Endometriosis, ascites, effusions, post-surgery, peritoneal effusion, peritonitis, cholelithiasis
CA 15-3 Mamma, ovary, cervix, endometrium Chronic inflammatory hepatic diseases, renal insufficiency, fibroadenoma, bronchial diseases, mastopathies
Ca 19-9 Pancreas, CRC, Esophagus, GIT, Liver, mucous membrane of the mouth/tongue Pancreatitis, Cholestasis, chronic active hepatitis, liver cirrhosis, Mucoviscidosis
CA 54-9 Mamma Hepatic diseases
CA 72-4 (TAG 72) Stomach, Ovary Acute pancreatitis, Hepatic cirrhosis, lung diseases, connective tissue diseases
Calcitonin Medullar thyroid gland carcinoma Renal insufficiency, hypogastrinemia, Hashimoto thyroiditis, hypercalcemia, pregnancy
CEA CRC, pancreas (CEA+u-Pa), intestinal tract, stomach, lungs, kidney, mamma, ovary, bladder Smokers (precancerous), hepatic cirrhosis, inflammatory disease of the lungs and the intestine, emphysema hepatitis, diverticulitis, M. Crohn, colitis ulcerosa, pneumonia
Chromogranin Endocrine tumours (neuroblastoma, carcinoid, pheochromocytoma, small-celled lung carcinoma Renal insufficiency, distinctive GIT absorption defect (malabsorption syndrome) M. Whipple and coeliac disease.
Cortisol Pituitary gland, adrenal cortex
Cyfra 21.1 Carcinoma of the lungs, cervix, oesophagus Pneumonia, M. Crohn, contamination with saliva (false elevated)
DHEA-S Pituitary gland/ adrenal cortex AGS, adrenal cortex hyperplasia, hirsutism, virilism
Dopamine Sympathetic cell tumours
Ferritin M.Hodgkin, leukaemia, lymphoma, kidney, (pancreas mamma) Iiron overloading, infections, hepatopathies, Still syndrome
Gastrin Gastrinoma
GH (HGH) HVL (acromegaly) Hypoglycemia (stress)
B-HCG Chorionepithelioma, hydatidiform mole, pregnancy, testicular tumour Pregnancy (also extrauterine)
5-HIAA Carcinoid Syndrome Food with serotonin, antiepileptics, celiac disease
Catecholamines Suprarenal gland medulla Stress, hypoglycemia, hypertonus, medicaments, stimulated sympathicotonus
M2 pyruvate kinase Proliferation activity of different tumours of the gastrointestinal section, lungs, mamma and renal cell carcinoma.
Metanephrines Suprarenal gland medulla
MIA Uveal melanoma
B2 – Microglobulin Lymphoma, multiple myeloma, lymphatic leukaemia, HIV Viral disease, tubular proteinuria
Neopterin Lymphoma, Leukaemia, HIV Viral diseases
NMP 22 Carcinoma of the bladder Interstitial cystitis, infections of the urine tract, invasive operations (cystoscopy, catheterism, OP)
NSE Small-celled bronchial carcinoma, neuroblastoma, melanoma Bronchopneumonia, lung fibrosis, hemolysis
u-PA Pancreas (particularly in combination with CEA)
PLAP Seminoma Smoking
Prolactin Pituitary gland Hyperthyroidism, stress, pregnancy, renal insufficiency, palpation of breasts, breastfeeding, drugs (dopamine antagonists, metoclopramide, antidepressants, neuroleptics, estrogen, antiacid medicine)
PCA 3 Prostate gland
PSA Prostate gland Prostate gland which has been examined manually or with instruments 12h before blood collection (also catheterisation as well as cystoscopy etc.) benign hypertrophy
ROMA-Index Ovarian carcinoma
SCC Cervix, oesophagus, mouth Lungs, squamous epithelium, dermatosis (psoriasis, eczema, pemphigus), nephropathies, liver cirrhosis, pancreatitis, chronic bronchitis, tuberculosis, and contamination with saliva reveals false increased results
Septin 9 Colon carcinoma
Serotonin Carcinoid Syndrome Smoking, drugs (MAO- inhibitors, reserpine, serotonin-containing food), Epilepsia, coeliac disease)
Testosterone Ovary/adrenal cortex AGS, hyperplasia of the adrenal cortex, androgen resistance, hyperandrogenemia, Cushing syndrome, PCO Syndrome
Thyroglobulin Papillary/follicular thyroid gland carcinoma Euthyroid struma, struma nodosa, M.Basedow, autonomous adenoma
TPA (TPS) Small-celled bronchial carcinoma, bladder, cervix, ovary, mamma Diseases of the lungs, GIT and urogenital tract, decompensated liver cirrhosis
VMA Adrenal medulla Essential hypertonus, stress, physical stress, hypoglycemia, drugs