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26 tumor markers and their clinical significance

26 tumor markers and their clinical significance, this article will help you summarize it!

There are many tumor markers ( TM), but what is the meaning of each index and what tumor is it applicable to? The author has summarized it, and hope it will be helpful to everyone.

Some common and general tumor serum TM

• CEA (carcinoembryonic antigen) is derived from cavity organs and has strong specificity for lung adenocarcinoma. Normal ≤ 3 ng/mL (non-smoker) ≤10 ng/mL (smoking),> 20 ng/mL indicates digestive tumors. It is a sign of metastasis and recurrence of a variety of tumors.
• CA125 (carbohydrate antigen 125) Ovarian TM, an independent TM for the prognosis of lung cancer; normal <35 u/mL.
• CA153 breast cancer is the first choice TM, which increases with the tumor stage; normal <28 ng/mL.
• CA199 is a digestive source, pancreatic cancer is the most sensitive (70%), followed by colorectal cancer (45%), liver cancer (30%); normal <37 U/mL.
• CA242 digestive source.
• NSE (Neuron Specific Enolase) Small cell lung cancer TM, glioma TM; neuroendocrine source, it is a signal of brain metastasis.
• SCC (Squamous Cell Carcinoma Associated Antigen), as its name suggests, is specific for squamous cell carcinoma; TM for cervical cancer.
• TPA (Tissue Polypeptide Antigen) reflects activity, differentiation, and infiltration.

Lung Cancer Serum TM

• CYFRA21-1 (Cytokeratin 21-1 Fragment) is the first choice for lung squamous cell carcinoma, with a sensitivity of 76.5% and a specificity of 87% for non-small cell lung cancer.
• Pro-gastrin-releasing peptide (ProGRP) TM for small cell lung cancer has good sensitivity and specificity. It can be found in the early stage and can be used for screening high-risk small cell lung cancer patients. It has been included in routine physical examination items in Japan.
• The positive rate of the product of p53 tumor suppressor gene p53 is related to the survival of lung squamous cell carcinoma after surgery.

Application

• Lung adenocarcinoma: CEA (87%), CA153
• Lung squamous cell carcinoma: SCC, CYFRA21-1
• Small cell lung cancer: pro-GRP, NSE
• Non-small cell lung cancer triple: CYFRA21-1 + CEA + p53
• Lung metastasis: CA199, CA153
• Relapse: CEA

Gastric Cancer Serum TM

• CA 72-4 Gastric Cancer Progression and Efficacy TM, independent prognostic factor.

None can meet the sensitivity and specificity of early diagnosis, usually combined diagnosis. Precancerous lesions and early stage: CA199, CA242, CA724, CEA increased.

Liver Cancer Serum TM

• AFP (Alpha Fetoprotein) Primary liver cancer and germline tumors TM. Normal ≤ 20 ng/mL, no liver disease activity, excluding pregnancy and gonad embryonic cancer, ≥ 400 ng/mL for 1 month or ≥ 200 ng/mL for 2 months, liver cancer can be diagnosed in combination with imaging examination.
• AFP also increases in patients with liver cirrhosis and hepatitis, but generally does not exceed 300 ng/ml.
• GP37 (Golgi protein 73) is the most promising predictor of early liver cancer.
• Early diagnosis of CK19 AFP-negative liver cancer has a sensitivity of 50% and a specificity of 90.9%.
• The sensitivity of CEA+AFP+CA125 can reach 95.83%.

Colorectal cancer serum TM

• CEA, CA242, and CA199 are more sensitive, but the combined detection is not better than a single CEA.
• ESM-1 (Endothelial Cell Specific Molecule-1) is normal <37.0 ng/mL, with a sensitivity of 90.91% and a specificity of 95%, which increase with the increase of TNM staging. It is the star of the future.

Cholangiocarcinoma serum TM

• CA199 has the highest diagnostic value and can be combined with CA242, CEA, and CA125 to assist in diagnosis.

Pancreatic Cancer Serum TM

• CEA + CA199 + TSGF triple.

Breast Cancer Serum TM

CA153: Early sensitivity is low (60%), late sensitivity is 80%, metastatic positive rate is high (80%), and late bone metastasis positive rate can reach 50%.

CA125: The positive rate of lymph node metastasis and infiltration reached 44.6%.

Prostate Cancer Serum TM

PSA (Prostate Cancer Specific Antigen) includes total PSA (t-PSA) and free PSA (f-PSA). Normal t-PSA<10 μg/L, fPSA<2.5 μg/L. f-PSA is more sensitive than t-PSA. When t-PSA is normal and f-PSA is elevated, it may indicate prostate cancer.

Ovarian Cancer Serum TM

• HE4 (human epididymal protein 4) has higher specificity, sensitivity and accuracy. CA125 is more sensitive to serous ovarian cancer than mucinous.
• CA125, CA153, AFP, HE4 (human epididymal protein 4) are more sensitive.

Bladder Cancer Urine TM

• NMP22 (nuclear matrix protein) differentiates benign and malignant bladder diseases.

Reproductive tumor serum TM

• HCG (human chorionic gonadotropin) Normal <8 U/L in non-pregnancy, tumor patients, generally test β-subunit-β-HCG.

It is the most basic marker for male testicular tumors and female malignant trophoblastic tumors (hydatidiform mole, aggressive hydatidiform mole, choriocarcinoma).

What should the ideal TM look like?

Should have the following 6 poins: 

1. High sensitivity: to facilitate early detection and early diagnosis;

2. High specificity: only tumor patients are positive and other diseases are negative, which can distinguish benign and malignant tumors;

3. It can be located: organ-specific, you can know whether it is lung cancer or breast cancer through TM;

4. Assess the condition: The progress, size, and severity of the tumor can be known through the positive rate and concentration of TM;

5. Monitoring the effect of treatment: the curative effect and recurrence of tumor treatment;

6. Predict the prognosis: the appearance of this TM will tell you whether the prognosis is good or not.

(source:internet, reference only)

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