Tumor Marker

Oncofetal proteins

AFP and CEA

What is AFP

Alpha fetoprotein → Act like albumin in embryo

What cancer is AFP high in

HCC, germ cell tumors (NSGCT), hepatoblastoma

High AFP in non cancer condition

Liver diseases, biliary tract obstruction, ataxia telangiectasis, tyrosinemia, pregnancy, infancy

What is CEA

Carcinoembryonic Antigen → Cell adhesion and inhibit apoptosis

What cancer is CEA high in

Colorectal, almost advanced adenocarcinoma

CEA is high in what non cancer conditions

Hepatitis, cirrhosis, alcoholic liver disease, obstructive jaundice, ulcerative colitis, Crohn’s disease, pancreatitis, bronchitis, emphysema, renal disease, smoking

What is PSA

Prostate Specific antigen → Semen liquefaction to promote release and motility of spermatozoa; Prostate specific not cancer specific

PSA is high in what non cancer conditions

BPH, prostatitis, UTI, urinary retention

What does lower % free PSA indicate

Higher probability of prostate cancer

What cancer is PSA high in

Prostate cancer

What is β-hCG

Human chorionic gonadotropin → Maintain CL to produce progesterone in pregnancy

What non cancer conditions is β-hCG high

Ectopic pregnancy, pituitary adenoma, pregnancy

What cancer is β-hCG high in

Trophoblastic and germ cell tumors

What is NSE

Neuron specific enolase → expressed in neuron, neuroendocrine cell and tumor

What cancer is NSE high in

SCLC, neuroendocrine tumors, neuroblastoma

What can cause falsely high NSE

Hemolysis of any form → Even mild will cause elevation

What is CA-125

Associated with MUC16 (large transmembrane mucin)

What non cancer conditions cause high CA 125

Endometriosis, acute pancreatitis, cirrhosis, peritonitis, inflammatory pelvic

disease, chronic renal failure, acute hepatitis, menstruation and pregnancy

What cancer is CA 125 high in

Epithelial ovarian cancer

What is CA 15-3

Associated with MUC1 (a transmembrane glycoprotein) → Cell adhesion and cancer pathogenesis

What benign conditions cause high CA 15-3

Benign liver/breast disease

What cancer is CA 15-3 high in

Breast cancer

What is CA 19-9

Function in cell adhesion

What cancer is CA 19-9 high in

Pancreaticobiliary cancer (most), gastric carcinoma (50%), colorectal carcinoma (30%)

Which of these tumor markers can be used to definitely diagnose cancer

NONE → Most are not specific and are only used for screening and monitoring → Additional screening test (imaging) is needed