General Health

What are the Possible Applications for Tumour Markers?

Overview

A tumour marker is a chemical found in or produced by a tumour or its host in reaction to the existence of the tumour that can be used to distinguish a tumour from normal tissue or to determine the presence of a tumour by blood or secretory measurements.

Cancer that is identified early on has the potential of being cured. The treatment’s goal is to diagnose cancer while a tumour is small enough to be surgically removed completely. Unfortunately, most cancers do not cause symptoms until the tumours have become too large to be surgically removed or the malignant cells have migrated to other organs (metastasis).

An ideal tumour marker would be specific for a specific cancer type while also being sensitive enough to detect small tumours for early diagnosis or screening. Tumour markers are particularly effective in assessing the course of osteoblastic lesions, such as those found in prostatic cancer with bone metastases. Patients with osteolytic lesions, such as breast cancer with bone metastases, have moderately high ALP levels.

High serum ALP levels are seen in liver metastases. Other cancers with hepatic infiltration, such as leukaemia, sarcoma, and lymphoma, also cause elevated serum ALP levels.

Tumour markers can also be discovered in cells, tissues, and bodily fluids. To determine the existence of cancer, immunological, chemical, or molecular biological approaches can be used to measure them qualitatively or quantitatively. Enzymes and isoenzymes, hormones, oncofetal antigens, carbohydrate epitopes, and other markers produced by tumours are examples of tumour markers.

The following are some of the possible applications for tumour markers:

  • Cancer staging in clinical practise
  • Differential diagnosis in patients with symptoms
  • The whole population can be screened
  • As a disease progression prognostic indicator.
  • Can aid in determining the treatment’s effectiveness
  • Detecting a cancer recurrence responses to therapy are being tracked.
  • Choosing an immunotherapy strategy

Inside the cell, enzyme concentrations are substantially higher than outside. As a result of tumour necrosis or a change in cancer cell permeability, enzymes are released into the cell’s systemic circulation. Increased enzyme levels are seen when the pancreatic or biliary ducts are blocked, as well as in renal insufficiency. On the other hand, most enzymes are not exclusive to a single organ. Additional organ specificity may be provided by isoenzymes and multiple enzyme forms. e Measuring the levels of the following enzymes can aid in the diagnosis of particular malignancies.

  • Alkaline phosphatase (ALP): ALP levels are elevated in primary and secondary liver cancers. Its level may be useful in assessing metastatic cancer that has spread to the bones or liver.
  • Creatine kinase (CK): The brain, prostate gland, gastrointestinal system, lung, bladder, uterus, and placenta possess CK1 isoenzyme. CK1 levels have been found to be elevated in prostate and lung small cell cancer. It may also be elevated in breast, colon, ovarian, and stomach cancers.
  • Lactate dehydrogenase (LDH) can be increased in cancer of the liver, acute leukaemia, breast cancer, colon cancer, stomach and lung cancer.
  • Prostatic acid phosphatase (PAP) elevated values PAP is seen in prostatic cancer, multiple myeloma, bone metastases of other cancers and osteogenic sarcoma.

Hormones as Tumor Markers 

Two distinct pathways are involved in the synthesis of hormones in cancer. It is created by organ tissue that generates it ordinarily, and it may also be made by nonendocrine tissue. Ectopic syndrome is the medical term for this disorder. The pituitary gland, for example, as well as a tiny lung cell, creates ACTH. As a result, high ACTH serum levels could be due to pituitary or ectopic production.

tumor markers

 

Oncofetal Antigens

They are proteins made during foetal development. These proteins are found in high concentrations in the sera of foetuses and then gradually decline or disappear after delivery. The reactivation of specific genes that produce oncofetal antigens occurs as a result of the malignant transformation of cells. Some of the most important oncofetal antigens are

  • ɑ-fetoprotein (AFP) which is a marker for hepatocellular and germ cell carcinoma.
  • and Carcinoembryonic antigen is a marker for colorectal, gastrointestinal, lung and breast carcinoma.

Carbohydrates as Tumor Markers

These tumour markers are a unique type of clinically relevant tumour indicators. They’re more precise than naturally produced markers like enzymes and hormones. These are either antigens on the surface of tumour cells or antigens released by tumour cells. High molecular weight mucins or blood group antigens are carbohydrate indicators.

  • CA 15.3 is a marker of breast carcinoma.
  • CA125 is a marker for ovarian and endometrial carcinomas. It is also elevated in pancreatic, lung, breast, colorectal, and other GIT tumours.

Author

 Yash Batra

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