Tumor Markers

Overview

Proteins released by neoplasm into circulation
Tumor markers should be used to
- confirm diagnosis
- monitor therapeutic response
- monitor tumor recurrence
- NOT as a means to diagnose cancer in absence of physical examination of the tissue (e.g. biopsy)

Reproductive Cancer Markers	Normal Function	Description
PSA (Prostate-specific antigen)	Liquefaction of semen	Prostate carcinomaalso released with BPH and prostatitisincrease in bound PSA (as compared to free PSA) is suggestive of cancer
Prostatic acid phosphatase		Prostate carcinoma
α-fetoprotein (AFP)	Fetal albumin	Hepatocellular carcinomasNonseminomatous germ cell tumors of the testise.g. yolk sac tumor
β-hCG	Normally released by placenta as a corpus luteum trophic hormone	Hydatidiform molesChoriocarcinomasGestational trophoblastic tumors
CA-125	Released by peritoneum with irritation (can be elevated in endometriosis)	Ovarian Epithelial tumors

Miscellaneous Cancer Markers	Description
TRAP (Tartrate-resistant acid phosphatase)	Hairy cell leukemia
CA-19-9	Pancreatic adenocarcinoma
Chromogranin	Neuroendocrine tumors
Calcitonin	Medullary carcinoma of the thyroid

Multicancer Markers	Description
S-100	Melanoma Neural tumorsAstrocytomas
Alkaline phosphatase	Marker of bone formationosteoblastic metastases to bone (e.g. prostate)Paget’s disease of boneAlso released when bile ducts are damagedobstructive biliary disease
Bombesin	NeuroblastomaLung cancerGastric cancer
CEA	Colorectal cancerPancreatic cancer

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