1	One Step Further Tumor Markers OSF - 4 Pages 44 - 46
2	Tumor Markers - 2 Definition: Tumor markers are expressions of mutated genes, viral genes, or abnormal expressions of normal host genes resulting in the production of a specific protein. First tumor marker identified was: eBence-Jones protein Žconsists of light chains of immunoglobulins Žproduced by transformed B lymphocytes Ž80% of individuals who have multiple myeloma produce these proteins Ž20% of pateints with Chronic Lymphocytic Leukemia (CLL) also form these proteins
3	Tumor Markers - 3 Old Tumor Markers that have been replaced by new ones: OLD MARKER DISEASE NEW MARKER Acid phosphatase Amylase prostate cancer PSA* *PSA = Prostate Specific Antigen pancreatic cancer CA19-9⁺ ⁺CA19-9 = Cancer Antigen 19-9
4	Tumor Markers - 4 Classification of Tumor Markers: eTumor-specific markers eTumor-associated markers eTissue-specific tumor markers Tumor-specific markers: emolecules that are expressed by tumor cells eMay consist of: Žnew antigenic protein Žaltered cellular protein Žabnormal membrane structural antigens eExamples of tumor-specific markers: ŽTerminal Deoxynucleotidyl Transfrase (TdT) ŽCA125 ŽCA19-9
5	Tumor Markers - 5 Tumor-specific markers: continued eExamples of tumor-specific markers: cont=d ŽTerminal Deoxynucleotidyl Transfrase (TdT) a DNA associated enzyme it is present in patients with Acute Lymphoblastic Leukemia (ALL) it is present in patients with non-hodgkin=s lymphoma of lymphoblastic type ŽCA125 associated with ovarian cancer ŽCA19-9 associated with pancreatic cancer currently under investigation for use
6	Tumor Markers - 6 Tumor-associated markers: emolecules that are expressed by different tumors originating from same cell type eBest characterized tumor-associated markers are the oncofetal antigens which are glycoproteins normally produced by embryonic tissue and not normally found at detectable levels in adults Žalpha-fetoprotein (AFP) Žcarcinoembryonic antigen (CEA) eExamples of tumor-associated markers: Žalpha-fetoprotein (AFP) Žcarcinoembryonic antigen (CEA) ŽB₂M ŽTAG-72
7	Tumor Markers - 7 Tumor-associated markers: continued eExamples of tumor-associated markers: cont=d ŽAlpha-fetoprotein (AFP) elevated levels in: hliver cancer hgerm cell tumors hgastric & pancreatic cancer elevated levels in cirrhosis of liver also ŽCarcinoembryonic antigen (CEA) elevated levels in: hliver cancer hcolon cancer hlung cancer hpancreas, bladder, cervical, and prostate cancer useful as screening method for above cancers useful for monitoring therapy in patients with above cancers
8	Tumor Markers - 8 Tumor-associated markers: continued eExamples of tumor-associated markers: cont=d ŽB₂M (Beta₂-microglobulin) elevated levels in: hmultiple myeloma hSystemic Lupus Erythematosus hRheumatoid Arthritis ŽTAG-72 (Tumor-associated antigen) elevated levels in: hbreast cancer hcolon cancer hlung cancer hstomach cancer hovarian cancer ŽB₂M & TAG-72 are currently under investigation
9	Tumor Markers - 9 Tissue-specific tumor markers: emolecules that are characteristic of a particular tissue type and do not induce an immune response since they are self-antigens eExamples of tissue-specific tumor markers: ŽCD-10 ŽsIgs - surface immunoglobulins ŽIL-2 receptors ŽPSA - prostate-specific antigen ŽCalcitonin
10	Tumor Markers - 10 Tissue-specific tumor markers: continued eExamples of tissue-specific tumor markers: cont=d ŽCD-10 or CALLA elevated levels in: hPre-B cell leukemias hLymphoblastic lymphomas of B- cell type ŽsIgs - (surface immunoglobulins) elevated levels in: hmature B-cell leukemias hlymphomas of mature B-cell type ŽIL-2 receptor elevated levels in: hT-cell leukemias ŽCalcitonin elevated levels in: hthyroid cancers
11	Tumor Markers - 11 Tissue-specific tumor markers: continued eExamples of tissue-specific tumor markers: cont=d ŽPSA - prostate-specific antigen elevated levels in: hprostate cancer used as a screening test for prostate cancer used to monitor therapy in diagnosed cases of prostate cancer much controversy as to usefulness and reliability of this marker
12	Tumor Markers - 12 Gene/chromosome markers: eThere are a couple of markers that are used in diagnosis: Žp53 gene: mutated form seen in: hcolorectal cancer ŽPh¹ chromosome also called the Philadelphia chromosome mutated form of chromosome is a translocation from chromosome 22 to chromosome 9 (t9,22) h85% of CML (chronic myelogenous leukemia) patients have this chromosome
13	Tumor Markers - E