TUMOR CANCERS WHAT ELSE?

WHEN/HOW USUAL
USED SAMPLE
MARKERS

AFP Liver, germ cell cancer Also elevated Help Blood

during pregnancy diagnose,
(Alpha-feto of ovaries or testes monitor
protein) treatment,
and
determine
recurrence

Multiple myeloma Present in many other Determine Blood

ß2M prognosis
(Beta-2 and lymphomas conditions, including
microglobulin) Crohn's disease
and hepatitis; often used
to determine cause of
renal failure

C A 15- 3 Breast cancer and Also elevated in benign Stage Blood

breast conditions; doctor disease,
(Cancer others, including lung,
can use CA 15-3 or CA monitor
antigen 15-3) ovarian treatment,
27.29 (two different
and
assays for same marker) determine
recurrence

CA 19-9 Pancreatic, Also elevated Stage Blood

in pancreatitis and disease,
(Cancer sometimes
inflammatory bowel monitor
antigen 19-9) colorectal and bile treatment,
ducts disease
and
determine
recurrence

CA-125 Ovarian Also elevated with Help Blood

endometriosis, some diagnose,
(Cancer monitor
antigen 125) other benign diseases
treatment,
and conditions; not
and
recommended as a determine
general screen recurrence

Calcitonin Thyroid medullary Also elevated Help Blood

in pernicious anemia and diagnose,
carcinoma monitor
thyroiditis
treatment,
and
determine
recurrence

CEA Colorectal, lung, Elevated in other Monitor Blood

conditions such as treatment
(Carcino- breast, thyroid, and
embryonic pancreatic, hepatitis, COPD,
determine
antigen) liver, cervix, and colitis, pancreatitis, and
recurrence
in cigarette smokers
bladder

Chromogranin Neuroendocrine May be most sensitive To help Blood

A (CgA) tumor marker for diagnose and
tumors (carcinoid monitor
tumors, carcinoid tumors
 neuroblastoma)

Estrogen Breast Increased in hormone- Determine Tissue

dependent cancer prognosis
receptors and guide
treatment

hCG Testicular and Elevated in pregnancy, Help Blood,

testicular failure diagnose, urine
(Human trophoblastic disease monitor
chorionic treatment,
gonadotropin) and
determine
recurrence

Her-2/neu Breast Oncogene that is present Determine Tissue

in multiple copies in 20- prognosis
30% of invasive breast and guide
treatment
cancer

Monoclonal Multiple myeloma and Overproduction of an Help Blood,

immunoglobulin or diagnose, urine
immuno- Waldenstrom’s monitor
globulins macroglobulinemia antibody, usually
treatment,
detected by protein
and
electrophoresis determine
recurrence

Progesterone Breast Increased in hormone- Determine Tissue

receptors dependent cancer prognosis
and guide
treatment

PS A Prostate Elevated in benign Screen for Blood

prostatic hyperplasia, and help
(Prostate diagnose,
specific prostatitis and with age
monitor
antigen), treatment,
to ta l a n d and
free determine
recurrence

Thyroglobulin Thyroid Used after thyroid is Determine Blood

removed to evaluate recurrence
treatment

Other
Tumor
Markers
Less Widely
Used

BTA Bladder Not widely available, but Help Urine

gaining acceptance diagnose and
(Bladder determine
tumor recurrence
antigen)

CA 72-4 Ovarian No evidence that it is Help Blood

better than CA-125but diagnose
(Cancer
antigen 72- may be useful when
4) combined with it; still
being studied

Des-gamma- Hepatocellular New test; often used To evaluate Blood

along with an imaging risk of
carboxy carcinoma (HCC) developing
prothrombin study plus AFP and/or
HCC; to
(DCP) AFP-L3% to evaluate if
evaluate
someone with treatment; to
chronic liver disease has monitor for
developed HCC recurrence

Solid tumors, such as Not available in every Guide Tissue

laboratory treatment
EGFR of the lung (non small and
(Her-1) cell), head and neck, determine
colon, pancreas, or prognosis
breast

NSE Neuroblastoma, May be better Monitor Blood

than CEA for following treatment
(Neuron- small cell lung cancer
specific this particular kind of
enolase) lung cancer

NMP22 Bladder Not widely used Help Urine

diagnose and
determine
recurrence

Prostate- Prostate Not widely used; levels Help Blood

increase normally with diagnose
specific
membrane age
antigen
(PSMA)

Prostatic Metastatic prostate Not widely used Help Blood

anymore; elevated in diagnose
acid cancer, myeloma, lung
phosphatase cancer prostatitis and other
(PAP) conditions

S-100 Metastatic melanoma Not widely used Help Blood

diagnose

Soluble
Mesothelin- Mesothelioma Often used in conjunction To monitor Blood
with imaging tests progression
Related or recurrence
Peptides
(SMRP)

TA-90 Metastatic melanoma Not widely used, being Help Blood

studied diagnose
Classification of Oncogenes
There are several systems for classifying oncogenes, but there is not yet a widely accepted
standard. They are sometimes grouped both spatially (moving from outside the cell inwards)
and chronologically (parallelling the "normal" process of signal transduction). There are several
categories that are commonly used:

Category Examples Cancers Gene functions

glioblastomas, fibrosarcomas,
Growth factors, induces cell
c-Sis osteosarcomas, breast
or mitogens proliferation.
carcinomas, and melanomas

epidermal growth
factor
receptor (EGFR),
platelet-derived
Breast cancer, gastrointestinal
growth factor transduce signals
Receptor stromal tumors, non-small-cell
receptor (PDGFR), for cell growth
tyrosine kinases lung cancer and pancreatic
and vascular and differentiation
cancer
endothelial growth
factor receptor
(VEGFR),
HER2/neu

colorectal and breast cancers,

Cytoplasmic Src-family, Syk- melanomas, ovarian cancers, mediate the
tyrosine kinases ZAP-70family, gastric cancers, head and neck responses to, and
and BTK family of cancers, pancreatic cancer, the activation
 tyrosine kinases, lung cancer, brain cancers, and receptors of cell
the Abl gene in blood cancers proliferation,
CML - Philadelphia migration,
chromosome differentiation,
and survival

Involved in
organism
Cytoplasmic Raf kinase,
development, cell
Serine/threonine and c yclin- malignant melanoma, papillary
cycle regulation,
kinases and dependent kinases thyroid cancer, colorectal
cell proliferation,
their regulatory (through cancer, and ovarian cancer
differentiation,
subunits overexpression)
cells survival, and
apoptosis

involved in
adenocarcinomas of the signalling a major
RegulatoryGTP
Ras protein pancreas and colon, thyroid pathway leading
ases
tumors, and myeloid leukemia to cell
proliferation

malignant T-cell lymphomas

and acute m yleoid leukemias,
Transcription breast cancer, pancreatic
myc gene
factors cancer, retinoblastoma, and
small cell lung cancer
They regulate
transcription of
genes that induce
cell proliferation

More detailed information for the above Table:

Growth factors are usually secreted by specialized cells to induce cell proliferation in
themselves, nearby cells, or distant cells. An oncogene may cause a cell to secrete growth
factors even though it does not normally do so. It will thereby induce its own uncontrolled
proliferation (autocrine loop), and proliferation of neighboring cells. It may also cause production
of growth hormones in other parts of the body.

Receptor Tyrosine Kinases add phosphate groups to other proteins to turn them on or off.
Receptor kinases add phosphate groups to receptor proteins at the surface of the cell (which
receive protein signals from outside the cell and transmit them to the inside of the cell). Tyrosine
kinases add phosphate groups to the amino acid tyrosine in the target protein. They can cause
cancer by turning the receptor permanently on (constitutively), even without signals from outside
the cell.

Ras is a small GTPase that hydrolyses GTP into GDP and phosphate. Ras is activated by
growth factor signaling (i.e., EGF, TGFbeta) and acting like a binary switch (on/off) in growth
signaling pathways. Downstream effectors of Ras include Raf, MEK, MEKK, MAPK, ERK, most
of which in turn regulate genes that mediate cell proliferation.