Tumor Markers Quiz

Which of the following statements concerning oncofetal antigens is incorrect?

 

Oncofetal antigens are synthesized by placental trophoblasts.

 

An example of an oncofetal antigen is alpha-fetoprotein.

 

Oncofetal antigens are sometimes glycoproteins.

 

Oncofetal antigens are found as normal proteins in an embryo.

• Oncofetal antigens are synthesized by placental trophoblast

Which of the following is NOT commonly used as a tumor marker?

 

Cortisol

 

Prostate specific antigen

 

Carcinoembryonic antigen

 

Alpha-fetoprotein

• cortisol

Clinical assays for tumor markers are most important for:

 

Confirming the absence of disease

 

Identifying patients at risk for cancer

 

Screening for the presence of cancer

 

Monitoring the course of a known cancer

• monitoring the course of a known cancer

Proteins found in normal fetal tissue and also in certain tumors are referred to as:

 

oncogenes.

 

tumor-associated antigens.

 

embryonic proteins.

 

oncofetal antigens.

• oncofetal antigens

The properties of an ideal tumor marker include all of the following, except it should:

 

be able to distinguish between benign and malignant tumors.

 

not be present in healthy people.

 

be produced by tumor cells and detectable in body fluids.

 

be specific for a given type of cancer.

• be able to distinguish between benign and malignant tumors

Follicular lymphoma occurs when the:

 

HER-2/neu gene is overamplified, causing excess p105 to be released.

 

bcl-2 gene on chromosome 18 is translocated to the immunoglobulin heavy chain locus on chromosome 14.

 

c-abl proto-oncogene and the BCR gene on a chromosome reciprocally translocate.

 

c-myc gene becomes juxtaposed to the heavy-chain locus on chromosome 14.

• bcl-2 gene on chromosome 18 is translocated to the immunoglobulin heavy chain locus on chromosome 14

A physical agent, such as exposure to ultraviolet light for an extended period of time, or a biological agent, such as a virus, may cause cancer. These agents are referred to as:

 

tumor markers.

 

oncogenes.

 

carcinogens.

 

tumor suppressors.

• carcinogens

Proto-oncogenes are present in the human genome to serve the function of:

 

directors of apoptosis.

 

virus suppressors.

 

repairmen of DNA.

 

regulators of cell growth and proliferation.

• regulators of cell growth and proliferation

Which one of the following tumor markers is not a carbohydrate-related tumor marker with its most important clinical use in the assessment of breast cancer recurrence?

 

CA 549

 

CA 15-3

 

CA 125

 

CA 27.29

• CA 125

Tumor-associated antigens composed of high-molecular-weight mucin-like glycoproteins include:

 

BRCA-1 and -2

 

p53 and Rb

 

PSA and AFP

 

CA 125 and CA 19-9

• CA 125 and CA 19-9

The most specific tumor marker for prostatic cancer is:

 

Prostate specific antigen

 

Human chorionic gonadotropin

 

Alpha-fetoprotein

 

Prostatic acid phosphatase

• PSA (Prostate specific antigen)

The fraction of a truly positive population among the positives in a given test is referred to as the:

 

negative predictive value.

 

positive predictive value.

 

prevalence.

 

clinical sensitivity.

• positive predictive value

An oncofetal antigen commonly used to assess recurrence of tumor growth following removal of a colon tumor would be:

 

CEA.

 

AFP.

 

cathepsin D.

 

CA 125.

• CEA

Activated forms of normal cellular genes are termed:

 

oncogenes.

 

pre-oncogenes.

 

oncofetal antigens.

 

proto-oncogenes.

• oncogenes

In general, in which of the following situations is the analysis of a glycoprotein tumor marker, such as carbohydrate-associated antigen-125 (CA-125), most useful?

 

Prognosis

 

Testing for recurrence

 

Screening

 

Diagnosis

• testing for recurrence

Which of the following enzymes is increased in persons with prostate and small cell lung cancer?

 

Creatine kinase-1 (CK-1)

 

Lactate dehydrogenase

 

Amylase

 

Gamma glutamyl transferase (GGT)

• Creatine kinase -1 (CK-1)

Which of the following is the best analyte to monitor for recurrence of ovarian cancer?

 

CA-125

 

CEA

 

CA-19-9

 

CA-15-3

• CA-125

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease?

 

Estrogen receptor (ER)

 

Retinoblastoma gene

 

Cathepsin-D

 

CA-15-3

• CA-15-3

What is the primary clinical utility of measuring CEA?

 

Screening for cancers of endodermal origin

 

Diagnosis of colorectal cancer

 

Monitoring for recurrence of cancer

 

Diagnosis of liver cancer

• monitoring for recurrence of cancer

A person is suspected of having testicular cancer. Which type of hCG test would be the most useful?

 

Urine assay for hCG β-core

 

Plasma immunoassay for intact hCG only

 

Plasma immunoassay for intact hCG and the β-hCG subunit

 

Plasma immunoassay for the free alpha and beta-hCG subunits

• plasma immunoassay for intact hCG and B-hCG subunit

A patient treated for a germ cell tumor has a total and free β-hCG assay performed prior to surgery. The result is 40,000 mIU/mL. One week after surgery, the hCG is 5,000 mIU/mL. Chemotherapy is started, and the hCG is measured 1 week later and found to be 10,000 mIU/mL. What does this indicate?

 

Falsely increased hCG as a result of drug interference with the assay

 

Recurrence of the tumor

 

Transient hCG increase caused by chemotherapy

 

Analytical error with the test reported as 5,000 mIU/mL

• transient hCG increase caused by chemotherapy

Which type of cancer is associated with the highest level of AFP?

 

Breast cancer

 

Ovarian cancer

 

Hepatoma

 

Testicular cancer

• Hepatoma

Which of the following assays is recommended as a screening test for colorectal cancer in persons over age 50 years?

 

CEA

 

AFP

 

Occult blood

 

Fecal trypsin

• occult blood

Which of the following assays is used to determine the risk of cancer?

 

c-erb B-2 gene expression

 

Squamous cell carcinoma (SCC) antigen

 

Epidermal growth factor receptor (EGFR)

 

p53 gene mutation

• p53 gene mutation

A person has elevated 24-hour urinary HVA and VMA levels. Urinary metanephrines, chromogranin A, and neuron-specific enolase levels are also elevated, but the 5-hydroxyindoleacetic acid (5-HIAA) level is within the reference range. What is the most likely diagnosis?

 

Carcinoid tumors of the intestine

 

Pheochromocytoma

 

Pancreatic cancer

 

Neuroblastoma

• neuroblastoma

Which of the following statements regarding PSA is true?

 

A total PSA less than 4 ng/mL rules out malignant disease

 

fPSA less than 25% is a risk factor for malignant disease

 

A total PSA greater than 10 ng/mL is diagnostic of malignant disease

 

Complexed PSA in plasma is normally less than free PSA (fPSA)

• fPSA < 25% is risk factor for malignant disease

A 55-year-old male with early-stage prostate cancer diagnosed through biopsy had his prostate gland removed (simple prostatectomy). His PSA prior to surgery was 10.0 ng/mL. If the surgery was successful in completely removing the tumor cells, what would the PSA result be 1 month after surgery?

 

Less than 10 ng/Ml

 

Undetectable

 

Less than 4 ng/mL

 

1 to 3 ng/mL

• undetectable

Which of the following genetic markers is associated with breast cancer?

 

Rb

 

BRCA-1 and -2

 

WT1

 

CA-125

• BRCA-1 and -2

The oncofetal antigen associated with liver cancer is:

 

PSA

 

AFP

 

CEA

 

hCG

• AFP

AFP and CEA are examples of which type of tumor marker?

 

Enzyme

 

Oncofetal antigen

 

Carcinoma-associated antigen

 

Hormone

• oncofetal antigen

The carcinoma-associated tumor antigen most useful for following patients with ovarian cancer is:

 

CA 72-4

 

CEA

 

CA 125

 

CA 15-3

• CA 125

CEA is most commonly associated with:

 

Myelocytic leukemia

 

Ovarian cancer

 

Colon cancer

 

Breast cancer

• colon cancer

Calculate the sensitivity for the following data: in a group of 80 patients diagnosed with sickle cell disease, 72 tested positively for it. The sensitivity of this test is:

 

90%.

 

111%.

 

100%.

 

75%.

• 90%

Nondiseased individuals that are classified as diseased by having a positive result on a specific laboratory test are considered:

 

false positives.

 

true positives.

 

false negatives.

 

true negatives.

• false positives

To calculate the sensitivity of a laboratory test to correctly classify true positives, one must first know the number of:

 

true positives and false positives.

 

true positives and false negatives.

 

true negatives and false positives.

 

false positives and false negatives.

 

• true positives and false negatives

The proportion of a population that has the particular disease being studied is referred to as the:

 

positive value.

 

prevalence.

 

clinical sensitivity.

 

predictive value.

• Prevalence