Tumor marker
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Tumor marker

Tumor markers - these are specific substances that appear in the blood and / or urine of cancer patients as a result of life of cancer (and sometimes normal) cells. They are very diverse in their structure, although very often represent proteins or derivatives thereof.

Tumor markers are of two types - a first type has a high specificity and occurs at a particular tumor type, the second type occurs when different types of cancer.
Tumor cell has the ability to allocate 1 picogram (10-12 g) tumor marker in the blood of 1 mg antigen, which in terms of the concentration gives about 200 ng / ml. Modern diagnostic methods are able to detect elevated

Identification of tumor markers enables:
- Indicate high risk for cancer
- To determine the possible source of tumor patients before the full survey
- Diagnose the possible occurrence of cancer recurrence
- Assess the impact of surgical treatment

The most commonly identified tumor markers

AFP (Alpha-fetoprotein) is similar in composition with albumin. In adults, the normal rate of AFP level is usually in the range of 15 ng / ml.
Concentration above 10 IU (international unit) / ml is pathological.
Tumor markers have an increased rate of AFP can inform about the presence of the following malignancies:
- Primary liver cancer
- Other metastases of malignant tumors in the liver (eg, breast cancer, rectum and sigmoid colon, lung)
- Teratocarcinoma yolk sac, ovary or testes (embryonal carcinoma)
In addition, the rate of AFP may increase in some benign diseases, such as liver cirrhosis, chronic and acute hepatitis, chronic renal failure. During pregnancy, an increase in the level of AFP may indicate violations of fetal development.
AFP is determined in plasma and amniotic fluid, bile, ascites and pleural fluids.

Beta-2-microglobulin determine in all cells except red blood cells and trophoblast cells. Normal levels of beta-2-microglobulin is present in small quantities in urine. Increased blood concentration informs renal insufficiency. Moreover, the indicator current level depends on the activity of a tumor marker of immunity, and may be increased at any inflammatory disease.
Analysis on Beta-2-microglobulin is necessary for suspected multiple myeloma, B-cell lymphocytic leukemia, lymphomas.

Evaluation of the prognosis depends on the survival index B2M - at above 3 ng / ml of a worse prognosis.
Tumor markers for beta-2-microglobulin is also taken into account when assessing survival after organ transplantation.

BONE TRAP protein is an enzyme of osteoclasts (bone cells deplete). The normal level for women under 45 years of not more than 1,1-3,9 IU / ml for women 45 - 55 years old - no more than 1.1-4.2 U / ml, and for menopausal women - no more than 1, 4-4,2 U / ml for men - the normal rate no greater than 1,5-4,7 IU / ml.
Bone TRAP marker is a tumor marker of bone metastases of breast cancer and prostate cancer as well as used as a marker to detect the presence of multiple myeloma bone. Often it is used for diagnosis of bone metastases. In addition, it allows you to assess the effectiveness of the treatment of bone metastases. Tumor markers Bone TRAP is also applicable for osteoporosis, hyperparathyroidism, Paget's disease.

CA 15-3, CA 27.29 - originally considered tumor markers in breast cancer. Their figure rises slightly (less than 10%) at the initial stages of the disease. However, with the development of the disease oncomarker figure reaches 75% or more.Enhancement of tumor markers CA 15-3, CA 27.29 arise in other types of tumors.
Normal value of CA 15-3 0-22 U / ml.
Index of more than 30 IU / ml informs pathology. 80% of women with metastatic breast cancer rate increased CA 15-3.
CA 15-3 are used in the determination of recurrence. Slight increase in markers of possible pregnancy.

CA 125 - a standard marker for ovarian cancer. More than 90% of patients with this diagnosis have a record of more than 30 CA 125 U / ml, however, this marker was used as a screening (sifting) kind of diagnosis. However, after it was revealed that this figure CA125 present in many healthy women, women with endometriosis, and pleural effusion in the abdominal cavity, as well as in patients with lung cancer and undergoing cancer earlier. Elevated levels observed during pregnancy and during menstruation.

CA 72-4, LASA-P - markers of ovarian cancer and tumors of the gastrointestinal tract.

CA 19-9 - tumor marker for pancreatic cancer, often used in the monitoring of the treatment. Pathological a concentration of 40 IU / ml and above. CA 19-9 indicator sometimes increases in certain types of bowel cancer and cancer of the bile passages.
Tumor markers are also used in the diagnosis and monitoring of treatment of pancreatic cancer, stomach cancer, colon cancer, colon cancer, gallbladder cancer.

CA 242 - one of the main markers used in diagnosis. Tumor marker CA 242 is detected in the same cases as CA 19-9, but has nabolee high specificity, thereby detecting cancer of the pancreas, colon and rectum in the early stages. Normal level marker CA 242: 0-30 IU / ml. Indicators allow you to specify the marker on the possible recurrence of malignant diseases of the gastrointestinal tract.

Kartsinoidoembrionalny antigen (CEA) - a marker of colorectal cancer, but can be used in the diagnosis of lung cancer and breast cancer, as well as other locations: thyroid, liver, bladder, cervix, pancreas, and often occurs in healthy smokers. For this reason, CEA to determine the category of non-specific tumor markers. Elevated levels consider reading above 5 U / ml.However, most of CEA used to confirm the identification of other methods of colon cancer.

Chromogranin A-producing tumors originating from cells of the nervous and endocrine systems.

Serum gamma globulin, is often detected in tumors of the bone marrow (multiple myeloma, macroglobulinemia).Regardless of the serum gamma globulin diagnosis should be confirmed by biopsy of the bone marrow.

Whey Her-2/neu- most often used to evaluate the prognosis of breast cancer. By increasing its level to 450 fmol / ml can talk about the low result of chemotherapy and poor prognosis for survival.

Human chorionic gonadotropin (HCG, HCG) - other than those listed previously able diseases occur in some tumors of the mediastinum.

NMP22-specific protein detectable in bladder cancer. NMP22 is mainly used to monitor the effectiveness of treatment, often instead of instrumental diagnosis (cystoscopy).

Neuron-specific enolase (NSE) - sometimes used in the assessment of patients with lung cancer and tumors originating from the neural and endocrine tissue.

NSE (neuron-specific enolase) - a protein enzyme that occurs in the lung and nervous tissues. The normal level is not more than 12.5 ng / ml.
NSE has a high sensitivity (45-86%) and specificity for lung cancer and is used to diagnose lung cancer and to determine the index of the effectiveness of therapy. In addition, it is applicable for the diagnosis of neuroendocrine tumors, carcinoids, pheochromocytomas, renal cancer, seminomas.

PSA (prostate specific antigen) - tumor marker used in the early stages of prostate cancer and other prostate diseases.Considered a good indicator of PSA less than 4 ng / ml. The presence of prostate cancer PSA index indicates greater than 10 ng / ml. PSA values ​​from 4 to 10 ng / ml are averages. Patients with level indicators PSA, prostate biopsy is necessary.
Besides prostate cancer, the PSA level increased in patients with benign prostatic hyperplasia, and in the elderly.
PSA is used as a sensitive test in determining the quality of treatment. After surgical removal or radiation therapy PSA indicator should be zero. Increased levels of PSA after treatment indicates a relapse of the disease.

CEA (carcinoembryonic antigen) tumor markers produced during pregnancy fetal cells of the digestive tract. Normal CEA levels - no more than 0-5 ng / ml. Increased CEA levels observed in malignant diseases: stomach, colon, rectum, lung, breast, ovary, uterus, prostate.
Slight increase in CEA indicates chronic renal failure, hepatitis and other chronic liver diseases.

S-10, TA-90 - onkomarkery skin cancer (melanoma). Often their rates go up when there are metastases.

SCC (squamous cell carcinoma antigen), squamous cell carcinoma tumor markers, is a protein that is synthesized in epithelial cells of the skin, bronchus, cervix, esophagus, anal canal. Normal level indicator - no more than 1.5 ng / ml.
SCC index increased in the presence of tumors of the squamous epithelium:
-Cervical cancer
-Tongue cancer,
-Head and neck cancer,
-Cancer of the esophagus,
-Lung cancer
-Cancer of the larynx,
-Vaginal cancer,
and other diseases:
-Skin disease (eczema, psoriasis)
-Chronic liver failure,
-Chronic renal failure.

CYFRA 21-1 - onkomarkery cancers. Normal level of no more than 2.3 ng / ml. CYFRA 21-1 is used to diagnose lung cancer cure rates, monitoring of patients with lung cancer and patients with other cancer diseases: cancer, cervical cancer, bladder cancer, esophageal cancer, ovarian cancer, breast cancer, colon cancer.

TG - precursor protein of thyroid hormones. Normal value Tg less than 60 ng / ml.
Tumor markers suitable for the TG of thyroid cancer as well as other diseases of the body, such as thyrotoxicosis, thyroiditis, thyroid toxic adenoma. Due to this, it is used to determine metastasis and disease recurrence in patients with thyroid cancer, and to identify the primary lesion in the presence of lung metastases and bone tumors unknown localization.

TU M2-PK reflects metabolism in the whole tumor. Normal value no greater than 17 U / ml, the border zone - 17-20 U / ml.
Level Tu M2-PK extend their kidney cancer, lung cancer, esophagus cancer, colorectal cancer, gastric cancer, breast cancer, pancreatic cancer. But the highest specificity (89%) and sensitivity (79%) tumor marker TU M2 PK has to kidney cancer, thanks to this, it is used to monitor patients with kidney cancer for cancer treatment efficiency index and early detection of recurrence.

Thyroglobulin - a protein produced by the thyroid glands, the level of which increases with its many diseases. Used as a tumor marker for monitoring patients who underwent surgical removal of the thyroid gland for cancer. Increased rate thyroglobulin (above 10ng/ml) informs tumor recurrence.

Tissue polypeptide antigen (TPA)-specific tumor markers of lung cancer.

UBC (Urinary Bladder Cancer) marker of bladder cancer. Specific test is very effective in the early stages. Determine the level of UBC in the urine in the bladder located more than 3 hours. Normal value level of 0.12 * 10-4 g / mol, malignant disease of the bladder level increases to 20,1-110,5 * 10-4 g / mol.

Tumor markers in different types of cancer

It is important to bear in mind that one is able to handle refer to different diseases, to determine the exact sequence of disease markers are used. For example, in the diagnosis of:
- Stomach cancer - CEA and CA 242,
- Pancreas - SF 242 and CA 19-9,
- Testicular cancer - AFP and hCG.
- A one-time increase in the level of tumor markers CA 19-9, CEA and AFP informs metastases to the liver.
Also important to realize that elevated levels of tumor markers performance is not necessarily informed about the presence of cancer. Therefore, biochemical analyzes are necessary to confirm the diagnostic studies.

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