Escolar Documentos
Profissional Documentos
Cultura Documentos
Althoughmostofthesecanbetestedinlaboratoriesthatmeetstandardssetbythe
ClinicalLaboratoryImprovementAmendments,somecannotbeandmaythereforebe
consideredexperimental.Tumormarkersthatarecurrentlyincommonusearelisted
below.
ALKgenerearrangements
Cancertypes:Nonsmallcelllungcancerandanaplasticlargecelllymphoma
Tissueanalyzed:Tumor
Howused:Tohelpdeterminetreatmentandprognosis
Alphafetoprotein(AFP)
Cancertypes:Livercancerandgermcelltumors
Tissueanalyzed:Blood
Howused:Tohelpdiagnoselivercancerandfollowresponsetotreatment;to
assessstage,prognosis,andresponsetotreatmentofgermcelltumors
Beta2microglobulin(B2M)
Cancertypes:Multiplemyeloma,chroniclymphocyticleukemia,andsome
lymphomas
Tissueanalyzed:Blood,urine,orcerebrospinalfluid
Howused:Todetermineprognosisandfollowresponsetotreatment
Betahumanchorionicgonadotropin(BetahCG)
Cancertypes:Choriocarcinomaandtesticularcancer
Tissueanalyzed:Urineorblood
Howused:Toassessstage,prognosis,andresponsetotreatment
BCRABLfusiongene
Cancertype:Chronicmyeloidleukemia
Tissueanalyzed:Bloodand/orbonemarrow
Howused:Toconfirmdiagnosisandmonitordiseasestatus
BRAFmutationV600E
Cancertypes:Cutaneousmelanomaandcolorectalcancer
Tissueanalyzed:Tumor
Howused:Topredictresponsetotargetedtherapies
CA153/CA27.29
Cancertype:Breastcancer
Tissueanalyzed:Blood
Howused:Toassesswhethertreatmentisworkingordiseasehasrecurred
CA199
Cancertypes:Pancreaticcancer,gallbladdercancer,bileductcancer,and
gastriccancer
Tissueanalyzed:Blood
Howused:Toassesswhethertreatmentisworking
CA125
Cancertype:Ovariancancer
Tissueanalyzed:Blood
Howused:Tohelpindiagnosis,assessmentofresponsetotreatment,and
evaluationofrecurrence
Calcitonin
Cancertype:Medullarythyroidcancer
Tissueanalyzed:Blood
Howused:Toaidindiagnosis,checkwhethertreatmentisworking,and
assessrecurrence
Carcinoembryonicantigen(CEA)
Cancertypes:Colorectalcancerandbreastcancer
Tissueanalyzed:Blood
Howused:Tocheckwhethercolorectalcancerhasspread;tolookforbreast
cancerrecurrenceandassessresponsetotreatment
CD20
Cancertype:NonHodgkinlymphoma
Tissueanalyzed:Blood
Howused:Todeterminewhethertreatmentwithatargetedtherapyis
appropriate
ChromograninA(CgA)
Cancertype:Neuroendocrinetumors
Tissueanalyzed:Blood
Howused:Tohelpindiagnosis,assessmentoftreatmentresponse,and
evaluationofrecurrence
Chromosomes3,7,17,and9p21
Cancertype:Bladdercancer
Tissueanalyzed:Urine
Howused:Tohelpinmonitoringfortumorrecurrence
Cytokeratinfragments211
Cancertype:Lungcancer
Tissueanalyzed:Blood
Howused:Tohelpinmonitoringforrecurrence
EGFRmutationanalysis
Cancertype:Nonsmallcelllungcancer
Tissueanalyzed:Tumor
Howused:Tohelpdeterminetreatmentandprognosis
Estrogenreceptor(ER)/progesteronereceptor(PR)
Cancertype:Breastcancer
Tissueanalyzed:Tumor
Howused:Todeterminewhethertreatmentwithhormonaltherapy(suchas
tamoxifen)isappropriate
Fibrin/fibrinogen
Cancertype:Bladdercancer
Tissueanalyzed:Urine
Howused:Tomonitorprogressionandresponsetotreatment
HE4
Cancertype:Ovariancancer
Tissueanalyzed:Blood
Howused:Toassessdiseaseprogressionandmonitorforrecurrence
HER2/neu
Cancertypes:Breastcancer,gastriccancer,andesophagealcancer
Tissueanalyzed:Tumor
Howused:Todeterminewhethertreatmentwithtrastuzumabisappropriate
Immunoglobulins
Cancertypes:MultiplemyelomaandWaldenstrmmacroglobulinemia
Tissueanalyzed:Bloodandurine
Howused:Tohelpdiagnosedisease,assessresponsetotreatment,andlook
forrecurrence
KIT
Cancertypes:Gastrointestinalstromaltumorandmucosalmelanoma
Tissueanalyzed:Tumor
Howused:Tohelpindiagnosinganddeterminingtreatment
KRASmutationanalysis
Cancertypes:Colorectalcancerandnonsmallcelllungcancer
Tissueanalyzed:Tumor
Howused:Todeterminewhethertreatmentwithaparticulartypeoftargeted
therapyisappropriate
Lactatedehydrogenase
Cancertype:Germcelltumors
Tissueanalyzed:Blood
Howused:Toassessstage,prognosis,andresponsetotreatment
Nuclearmatrixprotein22
Cancertype:Bladdercancer
Tissueanalyzed:Urine
Howused:Tomonitorresponsetotreatment
Prostatespecificantigen(PSA)
Cancertype:Prostatecancer
Tissueanalyzed:Blood
Howused:Tohelpindiagnosis,assessresponsetotreatment,andlookfor
recurrence
Thyroglobulin
Cancertype:Thyroidcancer
Tissueanalyzed:Blood
Howused:Toevaluateresponsetotreatmentandlookforrecurrence
Urokinaseplasminogenactivator(uPA)andplasminogenactivatorinhibitor(PAI1)
Cancertype:Breastcancer
Tissueanalyzed:Tumor
Howused:Todetermineaggressivenessofcancerandguidetreatment
5Proteinsignature(Ova1)
Cancertype:Ovariancancer
Tissueanalyzed:Blood
Howused:Topreoperativelyassesspelvicmassforsuspectedovariancancer
21Genesignature(OncotypeDX)
Cancertype:Breastcancer
Tissueanalyzed:Tumor
Howused:Toevaluateriskofrecurrence
70Genesignature(Mammaprint)
Cancertype:Breastcancer
Tissueanalyzed:Tumor
Howused:Toevaluateriskofrecurrence
Faseabdominal
Desinfeksilapanganoperasidenganantiseptikjugadilakukanirigasirektum
denganbahanantiseptik.
Lapanganoperasidipersempitdenganlinen/doeksteril.
Insisimidlineduajaridiatasumbilikussampaidiatassymphisispubis
diperdalamlapisdemilapissampaiperitoneum.Peritoneumdibukasecara
tajam.
Identifikasirektumdanditentukanresektabilitastumor.
Identifikasilesiataukelainanpadarektum,kelenjarmesorektum,hepar
(stagingtumor)
Mobilisasirektumdenganmelakukaninsisipadalateralrefleksiperitoneal
sambilmengidentifikasivasaspermatikaatauovarisertaureterdiisolasi.
A.mesenterikainferiordiikatdandipotongpadadistaldaripercabangana.
kolikamedia.
Mobilisasirektumposteriordenganmelakukandiseksisecaratajam,sehingga
sisiretrorektaldapatdicapai.Fasciarektorektaldipotong,setelahmemotong
fasciarektosakralberartisudahmencapaicoccygeus.
Mobilisasianteriordimulaidenganinsisirefleksirektovesikalpadalaki2dan
antararektumdanuteruspadawanita.Diseksidilanjutkandengan
memisahkanrektumdenganvesicaseminalispadalaki2danrektumdengan
vaginapadawanita.
Setelahmobilisasisisiposteriordananteriordilakukanidentifikasifascia
pelvis(ligamentumlateral),dipisahkan,dipotongdandiikat.
Karsinomarektumharusdieksisibersamamesorektumsecarautuh(Total
MesorectalExcision)
Dilanjutkandengantranseksirektumdiataslesi/tumordenganbatassesuai
kaidahonkologi.
Stumpproksimalrektumdimobilisasikeluardindingabdomendandibuat
permanentendcolostomy.
Dilakukanpenjahitansisaperitoneumuntukmenutupdasarpanggul.
Perdarahandirawatdanlukaoperasiditutuplapisdemilapis.
Faseperineal
Insisiellipssekelilinganussampaibatasm.sfingteranus.
Insisidiperdalamdenganinsisisirkumferensialmengelilingirektumdengan
memotongm.levatorani.Insisiterusdiperdalamsampaistumpdistalrektum
dicapaidandapatdikeluarkanmelaluiperineum.
Perdarahandirawatdanlukaoperasiditutuplapisdemilapisdengan
meninggalkandrainperineal(drainRedon).
Jaringantumorbesertarektumyangdireseksidandiperiksapatologi
anatominya.