Clinical Chemistry Exam 1 Lecture 9 – Flashcards
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| Cancer |
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| Uncontrolled cellular growth in the form of tumors |
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| What is the second cause of death in the United States of America? |
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| Cancer |
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| Highest Cancer Cases for Men Estimated in 2009 |
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| Prostate Lung Colorectal |
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| Highest Cancer Deaths for Men Estimated in 209 |
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| Lung Prostate Colorectal |
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| Highest Cancer Cases for Women Estimated in 2009 |
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| Breast Lung Colorectal |
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| Highest Cancer Deaths for Women Estimated in 2009 |
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| Lung Breast Colorectal |
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| Tumor Marker |
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| A substance released by a tumor or released by a tissue affected by a tumor |
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| Are Tumor Markers generally useful for screening? |
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| No |
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| Why are tumor markers generally not useful for screening? |
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| May be = in presence of tumor May be + in absence of tumor |
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| 6 Major Clinical Value of Tumor Markers |
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| Monitoring therapeutic response after diagnosis Detecting cancer recurrence Predicting patient prognosis Screening Confirmation of disease Tumor Staging |
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| 3 Basic types of tumor markers |
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| Proteins Tissue Receptors DNA-based |
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| Tissue Receptors |
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| Cell membrane proteins that bind to hormones |
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| When given the Protein Biomarker give the Cancer type: AFP |
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| Hepatocellular & germ cell |
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| When given the Protein Biomarker give the Cancer type: CA-125 |
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| Ovarian |
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| When given the Protein Biomarker give the Cancer type: HE4 |
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| Ovarian |
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| When given the Protein Biomarker give the Cancer type: Tg |
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| Thyroid |
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| When given the Protein Biomarker give the Cancer type: PSA |
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| Prostate |
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| When given the Protein Biomarker give the Cancer type: CEA |
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| Colon |
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| When given the Protein Biomarker give the Cancer type: CA 19-9 |
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| Colon and Pancreatic |
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| When given the Protein Biomarker give the Cancer type: CA 15-3/27-29 |
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| Breast |
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| When given the Protein Biomarker give the Cancer type: HER2/neu |
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| Breast |
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| HER-2-NEU |
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| Oncogene overexpressed in 20% invasive breast cancers |
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| HER-2-NEU used to determine what? |
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| Which drugs to use |
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| CA 15-3 is used to do what? |
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| Monitor response to treatment, to watch for recurrence, and to watch for metastases |
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| What type of tumors are associated with Human Chorionic Gonadotrophin - Beta HCG |
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| Hydatidiform mole Choriocarcinoma Testicular tumors Ovarian tumors |
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| Use a combination of what for monitoring response to therapy/recurrence of testicular cancer? |
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| AFP and HCG |
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| True or False: Beta HCG is usually undetectable in normal adult serum |
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| True |
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| Beta-2 Microglobulin |
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| Protein on the surface of WBCs, especially lymphs |
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| Does Beta-2 Microglobulin have value in prognosis? |
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| Yes |
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| What diseases are associated with Beta-2 Microglobulin? |
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| Multiple Myeloma Lymphomas |
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| What tests do you use to determine immunoglobulins? |
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| Protein electrophoresis IFE |
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| What diseases are associated with immunoglobulins? |
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| Multiple Myeloma Waldenstrom's |
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| Bladder Tumor-Associated Antigen (BTA): Test for in what sample? |
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| Urine |
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| What is the Leading cause of Bladder Cancer? |
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| Cigarette smoking |
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| You use BTA in conjuction with what else to detect recurrence of bladder disease? |
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| Cystoscopy |
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| What are the following used to determine: Estrogen and Progesterone Receptors |
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| Response to hormone therapy |
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| What type of receptors are Estrogen and Progesterone Receptors? |
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| Tissue Receptors |
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| What are the 9 FDA-Approved Protein Biomarkers? |
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| AFP CA 125 HE4 Tg PSA CEA CA 19-9 CA 15-3 HER-2-NEU |
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| Alpha-Fetoprotein has the highest levels in the fetus and _____ amounts in adults |
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| negligible |
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| What types of diseases are associated with Alpha-Fetoprotein (AFP)? |
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| Testicular cancer Hepatocellular carcinoma |
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| Where is Alpha-Fetoprotein used as a screen? |
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| Only in countries where liver cancer occurs at a high rate |
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| CA 125 80% Positive |
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| Ovarian Cancer |
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| CA 125 High levels post-surgery are associated with ______ prognosis |
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| poorer |
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| CA 125 is also elevated with ________ |
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| endometriosis |
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| HE4 is the newest marker that is used to determine what? |
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| Ovarian cancer recurrence |
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| Thyroglobulin should be ____ after resection |
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| Low |
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| Thyroglobulin is associated with which organ? |
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| Thyroid |
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| What disease is Thyroglobulin elevated in? |
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| Grave's Disease |
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| PSA is what type of screen? |
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| Prostate Cancer Screen |
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| Only ___ amounts of PSA in healthy men |
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| trace |
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| Do levels of PSA increase or decrease with age? |
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| Increase |
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| PSA plus what is the Best Screen? |
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| DRE |
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| What % of PSA is bound to serum proteins |
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| 70-80% |
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| What % of PSA is free? |
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| A Smaller Percentage |
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| Total PSA = |
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| Bound + Free |
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| Free PSA % = |
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| Free / Total PSA |
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| PSA is also elevated in what? |
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| Benign Prostatic Hyperplasia (BPH) |
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| ____% PSA indicates higher risk of cancer |
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| <25 |
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| What type of cancer is Carcinoembryonic Antigen (CEA) associated with? |
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| Colon Cancer |
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| Other than Colon Cancer what other types of cancer is Carcinoembryonic Antigen (CEA) associated with? |
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| Breast Cancer Lung Cancer Pancreatic Cancer Rectal Cancer |
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| Is CEA very sensitive? |
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| No, 35% of colorectal cancer patients have = CEAs |
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| Is CEA supposed to be used as a screen for colorectal cancer? |
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| No |
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| True or False: Cigarette smokers have higher levels of CEA than nonsmokers |
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| True |
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| What disease is CEA increased in? |
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| COPD |
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| What is CEA most frequently used for? |
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| Cancer Management |
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| True or False: CEA is the most frequently used tumor marker in cancer management |
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| True |
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| What type of cancers is CA 19-9 associated with? |
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| Pancreatic, Colon, and Bile Duct Cancers |
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| CA 19-9 is Elevated in about ____% of those with bile duct cancer |
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| 65 |
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| True or False: Non-cancerous causes of bile duct obstruction can cause very high CA 19-9 levels which fall when the blockage is cleared |
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| True |
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| What is the leading type of cancer in women? |
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| Breast Cancer |
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| What is the leading type of cancer in men? |
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| Prostate Cancer |
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| What is the formula for a free PSA%? |
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| >25% is Good |
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| What is the usefulness of calculating a fPSA%? |
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| Differentiate Cancer from BPH |
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| What tissue markers are frequently used to determine the expected response to hormone treatment in a woman with breast cancer? |
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| CA 15-3 HER-2-NEU |
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| What hormone marker is used to monitor the progression of both uterine cancer and testicular cancer? |
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| Beta-HCG |
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| Name the marker used with multiple myeloma patients to establish initial prognosis |
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| Beta-2 Microglobulin |
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| Name the marker used with multiple myeloma patients to monitor progression |
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| Immunoglobulins |
