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- tumer marker
A tumor marker is a substance found in the blood, urine, or body tissues that can be elevated in cancer, among other tissue types.
- There are many different tumor markers, each indicative of a particular disease process,
- An elevated level of a tumor marker can indicate cancer; however, there can also be other causes of the elevation.
Description
1- Screening for common cancers on a population basis
Example: elevated prostate specific antigen suggests prostate cancer.
2- Monitoring of cancer survivors after treatment
Example: elevated AFP in a child previously treated for teratoma suggests relapse with endodermal sinus tumor.
3- Diagnosis of specific tumor types, particularly in certain brain tumors and other instances where biopsy is not feasible.

Classification
Tumor markers can be classified in two groups:
Cancer-specific markers
tissue-specific markers.

Cancer-specific markers
Cancer-specific markers are related to the presence of certain cancerous tissue. Because there is a large overlap between the many different tumor tissue types and the markers produced these markers might not be specific in making a diagnosis. They can, however, be useful in the follow-up of treated patients to describe progress of the disease or response to treatment. A few examples of these markers are
CEA, CA19-9, CA125.

Tissue-specific markers
Tissue-specific markers are related to specific tissues which have developed cancer. Generally speaking, these substances are not specifically related to the tumor, and may be present at elevated levels when no cancer is present. But unlike the previous group, elevated levels point to a specific tissue being at fault. Examples include PSA, beta-HCG - (Human chorionic gonadotropin), AFP - (Alpha-fetoprotein), AFP-L3 - (a lectin-reactive AFP) and Thyroglobulin.
PSA (Prostate specific antigen) is produced by the normal prostate.
It is a protein enzyme called a serine protease that usually acts as an anticoagulant to keep semen liquid.
Only small amounts leak into the circulation in normal circumstances.
Enlarged prostates leak more substantial amounts, and cancerous prostates also leak substantial amounts.
An accurate way to tell if an elevated PSA level results from cancer is to biopsy the prostate.

CA15-3:
Elevated CA15-3, in conjunction with alkaline phosphatase, was shown to increase chances of early recurrence in breast cancer.
Elevated blood levels are found in less than 10% of patients with early disease and in about 70% of patients with advanced disease.
The normal level is usually less than 30 U/mL (units/milliliter),


Alpha-fetoprotein (AFP)
AFP can be helpful in the diagnosis and treatment of liver cancer (hepatocellular carcinoma).
Normal levels of AFP are usually less than 10 ng/mL
AFP levels are increased in most patients with liver cancer.
AFP is also elevated in acute and chronic hepatitis, but it seldom gets above 100 ng/mL in these diseases.

Beta-2-microglobulin (B2M)
B2M blood levels are elevated in multiple myeloma, chronic lymphocytic leukemia (CLL), and some lymphomas.
Levels may also be higher in some non-cancerous conditions, such as kidney disease. Normal levels are usually below 2.5 mg/L
B2M is useful to help predict the long-term outlook (prognosis) in some of these cancers.
Human chorionic gonadotropin (HCG)
HCG (also known as beta-HCG) blood levels are elevated in patients with some types of testicular and ovarian cancers (germ cell tumors) and in gestational trophoblastic disease, mainly choriocarcinoma.
Bladder tumor antigen (BTA)
BTA is found in the urine of many patients with bladder cancer.
It may be a sign of some non-cancerous conditions, too, such as kidney stones or urinary tract infections.
The results of the test are reported as either positive (BTA is present) or negative (BTA is not present).
CA 27.29 is another marker that can be used to follow patients with breast cancer during or after treatment.

CA 125
CA 125 is the standard tumor marker used to follow women during or after treatment for epithelial ovarian cancer (the most common type of ovarian cancer). Normal blood levels are usually less than 35 U/mL (units/milliliter).
CA 72-4
CA 72-4 is a newer test being studied in ovarian and pancreatic cancer and cancers starting in the digestive tract, especially stomach cancer. There is no evidence that it is better than the tumor markers currently in use, but it may be valuable when used along with other tests. Studies of this marker are still in progress.

CA 19-9
The CA 19-9 test was first developed to detect colorectal cancer, but it is more often used in patients with pancreatic cancer. In very early disease the level is often normal, so it is not good as a screening test. Still, it is the best tumor marker for following patients with cancer of the pancreas.
Normal blood levels of CA 19-9 are below 37 U/mL (units/milliliter). A high CA 19-9 level in a newly diagnosed patient usually means the disease is advanced.

Calcitonin
Calcitonin is a hormone produced by cells called parafollicular C cells in the thyroid gland. It normally helps regulate blood calcium levels. Normal calcitonin levels are below 5 to 12 pg/ml
In medullary thyroid carcinoma (MTC), a rare cancer that starts in the parafollicular C cells, blood levels of this hormone are often greater than 100 pg/ml.

Carcinoembryonic antigen (CEA)
CEA is not used to diagnose or screen for colorectal cancer, but it is the preferred tumor marker to help predict outlook in patients with colorectal cancer.
The normal range of blood levels varies from lab to lab, but levels higher than 3 ng/mL are not normal.
The higher the CEA level at the time colorectal cancer is detected, the more likely it is that the cancer is advanced.

Chromogranin A
Chromogranin A (CgA) is made by neuroendocrine tumors,
which include carcinoid tumors, neuroblastoma, and small cell lung cancer.
The blood level of CgA is often elevated in people with these diseases.
It is probably the most sensitive tumor marker for carcinoid tumors
Hormone receptors
Breast tumor samples -- not blood samples -- from all cases of breast cancer are tested for estrogen and progesterone receptors.
Breast cancers that contain estrogen receptors are often referred to as "ER-positive;" those with progesterone receptors are "PR-positive."
These cancers tend to grow more slowly and have a better outlook than cancers without these receptors.
Cancers that have these receptors can be treated with hormone therapy such as tamoxifen or aromatase inhibitors.
HER2 (also known as HER2/neu, erbB-2, or EGFR2)
HER2 is a protein that tells breast cancer cells to grow. It is elevated in some breast cancers.
The HER2 level is usually found by testing a sample of the cancer tissue itself, not the blood.

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مشكوررر ع الردود الجميله لك مني اجمل تحيه

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