Transcript TUMOUR MARKERS IN GYNAECOLOGY

EKUSILENI CLINICAL
LABORATORY
PSA AND CEA AS
SURROGATE MARKERS
FOR CANCER DIAGNOSIS
TALENTS MURAHWA
(BIOMEDICAL SCIENTIST)
LAB & CANCER MANAGEMENT
What are tumor markers
 Definition: – A tumour marker is a biochemical indicator selectively
produced by the neoplastic tissue and released into
blood and detected in blood or in other body fluids.
 It may be used to: – Detect the presence of a tumour
– Monitor the progress of disease
– Monitor the response to treatment
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Tumour Markers: - Classification
 Class 1: Antigens unique to a neoplasm not shared
by other tumours of same histological type .
 Class 2: Antigens expressed by many or most
tumours of a specific histological type and of other
histological type,
– But not expressed by normal adult tissue.
 Class 3: Antigens expressed by both cancer and
normal adult tissue.
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NATURE OF TUMOUR
MARKERS
 1.Oncofetal antigens
– Alpha Feto Protein
– CEA
– Pancreatic Oncofoetal Antigen
 2.Proteins
– Casein – By breast carcinoma
– Ferritin- Leukaemia
 3.Enzymes
– Creatinekinase – Prostate tumour
– Alkaline Phosphatase – Lungs tumour
– Acid Phosphatase – Prostate tumour
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4. Receptors
– Oestrogen, Progesterone, Androgen
5. Polyamines
– Spermine, Spermidine, Putridine – leukemia,
lymphoma, colorectal CA
6. Cell Markers
– T cell marker, B cell marker-lymphoma
7. Ectopic Hormones
– HCG, GH, Erythropoetin, Renin
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 LOCAL LABORATORY TESTS ON OFFER
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1.Alfa Feto Protein
2.CEA
3.PSA
ALPHA AMYLASE
LDH
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Alfa Feto Protein: Measurement of maternal serum and amniotic fluid levels
play an important role in the screening for
– Foetal neural tube defects
– Chromosomal abnormalities including Down’s Syndrome.
 Most measurements are done at 16 weeks of gestation.
 Raised maternal serum AFP levels are not specific for
neural tube defects.
 Must be used in combination with other modalities such as
USG, amniotic fluid AFP and acetylcholine esterase.
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Alfa Feto Protein: Many fetal conditions are associated with
abnormal maternal serum AFP levels.
– Elevated:
 NTD, GI obstruction, Liver necrosis, Abdominal wall defects
(Omphalocele, Gastroschisis), Sacrococcygeal tumour, Cystic
hygroma, IUGR, multiple pregnancies, renal anmalies.
– Low:
 Chromosomal trisomies (Down’s syndrome), Gestational
trophoblastic diseae, IUD, placental defects, GA
underestimated, Foetal distress, Hydrops Foetalis, TOF,
Cyclopia.
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Alfa Feto Protein: After birth AFP usually falls, within 8 to 12 months
of delivery to a very low conc.of 10mcg/ml and
persists at this low level throughout life.
 Unexplained and persistent elevation of AFP in
nonpregnant state should be screened, as it may
be due to– Hepatocellular Ca, germ cell tumour, hereditary
persistence of AFP, viral hepatitis and cirrhosis .
 In addition to its role in prenatal diagnosis, it is
also widely used in the diagnosis, therapeutic
monitoring and follow up of patients in germ cell
tumours.
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Germ Cell Tumours Producing
AFP
AFP
1. Dysgerminoma
--
2. Endodermal Sinus tumour /
+
yolk sac tumour
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2. Immature tetratoma
+/-
4. Mixed germ cell tumour
+/-
5. Choreocarcinoma
--
6. Embryonal CA
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CEA: It is a glycoprotein of mol.wt 200kda.
 Though it is a tumour marker for GI cancers, it is
also expressed by
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–
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malignant mucinous tumor (100%),
100% cases of atypical hyperplasia of endometrium,
60% cases of endometrial Ca,
50-80% cases of squamous cell of Cx,
75-100% cases of adenocarcinoma of Cx.
 It is also produced in pneumonia, hypothyroidism
and pancreatic tumours.
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PSA
 Prostate-Specific Antigen (PSA)
 A prostate-specific antigen (PSA) test
measures the amount of prostatespecific antigen in the blood. PSA is
released into a man's blood by his
prostate gland.
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 Healthy men have low amounts of PSA in
the blood. The amount of PSA in the
blood normally increases as a man's
prostate enlarges with age. PSA may
increase as a result of an injury, a digital
rectal exam, sexual activity (ejaculation),
inflammation of the prostate gland (
prostatitis), or prostate cancer
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PSA Why is it done?
 Why It Is Done
 The prostate-specific antigen (PSA) test is done
to:
 Monitor prostate cancer and how it responds
to treatment. If PSA levels increase, the cancer
may be growing or spreading. PSA is usually
not present in a man who has had his prostate
gland removed. A PSA level that rises after
prostate removal may mean the cancer has
returned or has spread.
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PSA
 Prostate cancer often grows very slowly,
without causing major problems.
Detecting prostate cancer early and
treating it may prevent some health
problems and reduce the risk of dying
from the cancer. However, some
treatments for prostate cancer can cause
other problems, such as
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PSA
 Determine if cancer may be present when
other tests, such as a digital rectal exam,
are not normal. A PSA test does not
diagnose cancer, but it can be used along
with other tests to determine if cancer is
present.
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PSA
 Check men for prostate cancer. Experts disagree
on the usefulness of PSA testing as a screening
tool for prostate cancer. If a PSA test is used for
screening, it is usually done for men older than
age 50 or for those at high risk for prostate cancer,
such as men with a family history of prostate
cancer, or for African-American men who have a
higher chance of developing cancer than other
men. Since other common medical conditions,
such as prostatitis, can cause high PSA levels, a
prostate biopsy is needed to confirm a diagnosis
of cancer.
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CONCLUSION
TM cannot be NECESSARILY
constructed as primary modalities for
diagnosis of tumours
THANK YOU
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