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Cancer Biochemistry
Tumour marker
• Any substance that can be related to the
  presence or progress of a tumour.
• Hormones: human gonadotrophin (HCG)
  secreted by choriocarcinoma
• Enzymes: prostate specific antigen (PSA) in
  prostate carcinoma
• Tumour antigens: carcinoembryonic antigen
  (CEA) in colorectal carcinoma
Biochemistry cancer
Biochemistry cancer
The use of tumour markers
Monitoring treatment
• Surgery, chemotherapy, radiotherapy

Assessing follow-up
• To monitor the marker long after the levels have
  appeared to stabilized

Diagnosis
• Detection in blood, biopsy
Prognosis
• To be of value in prognosis, the
  concentration of the tumour marker in
  plasma should be correlate with tumour
  mass.
• Eg: HCG correlates well with the tumour
  mass in choriocarcinoma
• HCG and AFP correlate with the tumour
  mass in testicular teratoma
• Paraproteins correlate with the tumour
  mass in multiple myeloma.
Screening for the presence of disease
• Specific high-risk population
• Eg: hormone calcitonin, which is
  increased in all patients with medullary
  carcinoma of thyroid, may be used to
  screen close relatives.
The important tumour markers:
•   Alkaline phosphatase (ALP)
•   Lactate dehydrogenase (LDH)
•   Prostatic acid phosphatase (PAP)
•   Prostate specific antigen (PSA)
•   Human chorionic gonadotropin (HCG)
•   Alpha-fetoprotein (AFP)
•   Carcino-embryonic antigen (CEA)
• CA-15 : marker for breast carcinomas
• CA-125 : marker for ovarian and
  endometrial carcinoma
• Calcitonin (secreted by cells of thyroid
  gland. Increased in medullary tumour of
  thyroid gland)

*carcinoma: cancer arising from epithelial
            tissue.
sarcoma: cancer from connective tissue
•   ALP
-   Primary or secondary liver cancer
-   Secondary bone cancer
-   Lung cancer
-   Cancer of GIT and ovary
-   Hodgkin’s disease
• PAP
-malignant conditions: cancer of prostate,
  multiple myeloma, osteogenic sarcoma.
-benign conditions: prostatic hypertrophy
  (BPH) or enlarged prostate, osteoporosis
  and hyperparathyroidism.
• PSA
-superior marker for prostatic cancer.
• Human Chorionic Gonadotropin (HCG)
-placental hormon. Synthesized by
   syncytiotrophoblastic cells of placental
   villi.
-choriocarcinoma. About 50% of cases of
   choriocarcinoma follow hydatidiform
   mole pregnancy and HCG is used to
   screen these women.
-ideal tumour marker for diagnosing and
   monitoring gestational trophoblastic
   tumours and germ cell tumours of testes
   and ovary.
• Alpha-Feto Protein (AFP)
-like CEA, AFP is another oncofetal antigen.
   AFT is synthesized in liver, yolk sac and GI
   tract in fetal life and released into serum
   of fetus.
-AFP is the more specific and ideal tumour
   marker for primary carcinoma of the liver
   (hepatocellular carcinoma)
-serum AFP and HCG are best available
   tumour markers for germ cell type of
   tumours.
• Cancer antigen 125 (CA-125)
-used for screening and diagnosis of ovarian
  carcinoma
-not specific for ovarian carcinoma

• CA 15-3 & CA-27.29
- useful as tumour marker in breast carcinoma

• CA 19-9
-useful as tumour marker in pancreatic cancer
  and biliary tract cancers.
Hormones
• produced by many tumors
• natural product or represent abnormal
  synthesis
• eg: insulin by islet cell tumor, calcitonin by
  medullary thyroid carcinoma, catecholamines
  by pheochromocytoma
• ectopic hormones - ACTH and ADH by lung
  cancer

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Biochemistry cancer

  • 2. Tumour marker • Any substance that can be related to the presence or progress of a tumour. • Hormones: human gonadotrophin (HCG) secreted by choriocarcinoma • Enzymes: prostate specific antigen (PSA) in prostate carcinoma • Tumour antigens: carcinoembryonic antigen (CEA) in colorectal carcinoma
  • 5. The use of tumour markers Monitoring treatment • Surgery, chemotherapy, radiotherapy Assessing follow-up • To monitor the marker long after the levels have appeared to stabilized Diagnosis • Detection in blood, biopsy
  • 6. Prognosis • To be of value in prognosis, the concentration of the tumour marker in plasma should be correlate with tumour mass. • Eg: HCG correlates well with the tumour mass in choriocarcinoma • HCG and AFP correlate with the tumour mass in testicular teratoma • Paraproteins correlate with the tumour mass in multiple myeloma.
  • 7. Screening for the presence of disease • Specific high-risk population • Eg: hormone calcitonin, which is increased in all patients with medullary carcinoma of thyroid, may be used to screen close relatives.
  • 8. The important tumour markers: • Alkaline phosphatase (ALP) • Lactate dehydrogenase (LDH) • Prostatic acid phosphatase (PAP) • Prostate specific antigen (PSA) • Human chorionic gonadotropin (HCG) • Alpha-fetoprotein (AFP) • Carcino-embryonic antigen (CEA)
  • 9. • CA-15 : marker for breast carcinomas • CA-125 : marker for ovarian and endometrial carcinoma • Calcitonin (secreted by cells of thyroid gland. Increased in medullary tumour of thyroid gland) *carcinoma: cancer arising from epithelial tissue. sarcoma: cancer from connective tissue
  • 10. ALP - Primary or secondary liver cancer - Secondary bone cancer - Lung cancer - Cancer of GIT and ovary - Hodgkin’s disease
  • 11. • PAP -malignant conditions: cancer of prostate, multiple myeloma, osteogenic sarcoma. -benign conditions: prostatic hypertrophy (BPH) or enlarged prostate, osteoporosis and hyperparathyroidism. • PSA -superior marker for prostatic cancer.
  • 12. • Human Chorionic Gonadotropin (HCG) -placental hormon. Synthesized by syncytiotrophoblastic cells of placental villi. -choriocarcinoma. About 50% of cases of choriocarcinoma follow hydatidiform mole pregnancy and HCG is used to screen these women. -ideal tumour marker for diagnosing and monitoring gestational trophoblastic tumours and germ cell tumours of testes and ovary.
  • 13. • Alpha-Feto Protein (AFP) -like CEA, AFP is another oncofetal antigen. AFT is synthesized in liver, yolk sac and GI tract in fetal life and released into serum of fetus. -AFP is the more specific and ideal tumour marker for primary carcinoma of the liver (hepatocellular carcinoma) -serum AFP and HCG are best available tumour markers for germ cell type of tumours.
  • 14. • Cancer antigen 125 (CA-125) -used for screening and diagnosis of ovarian carcinoma -not specific for ovarian carcinoma • CA 15-3 & CA-27.29 - useful as tumour marker in breast carcinoma • CA 19-9 -useful as tumour marker in pancreatic cancer and biliary tract cancers.
  • 15. Hormones • produced by many tumors • natural product or represent abnormal synthesis • eg: insulin by islet cell tumor, calcitonin by medullary thyroid carcinoma, catecholamines by pheochromocytoma • ectopic hormones - ACTH and ADH by lung cancer