March 5, 2024

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The most comprehensive interpretation of 49 tumor markers

The most comprehensive interpretation of 49 tumor markers



The most comprehensive interpretation of 49 tumor markers.


Tumor markers ( TM) refer to those synthesized and secreted by the gene expression of tumor cells or abnormally produced and/or increased by the body’s response to tumors during the occurrence and proliferation of malignant tumors, reflecting the existence and A type of substance that grows.


TM has an important prompting significance for the existence of tumors, and more and more blood TMs have become a hot spot in the early diagnosis of tumors, which has attracted the attention of clinicians.


The most comprehensive interpretation of 49 tumor markers


Common generic TM

CEA (Carcinoembryonic Antigen)

It is a traditional non-specific broad-spectrum TM, the normal value is ≤ 5 ng/mL, and the positive rate of CEA in the diagnosis of lung adenocarcinoma is as high as 80%. Increases can also be seen in colorectal cancer, pancreatic cancer, gastric cancer, breast cancer, etc., and can be used to monitor tumor recurrence and metastasis.

CA125 (Carbohydrate Antigen 125)

Normal value: 0.1 ~ 35 U/mL; CA125 is the preferred marker for ovarian cancer and endometrial cancer, and has a high positive rate in non-small cell lung cancer. Slightly increased can be seen in a variety of benign diseases, such as ovarian tumors, uterine fibroids, cervicitis, liver cirrhosis and hepatitis.

CA199 (Carbohydrate Antigen 19-9)

Normal value: 0.1 ~ 37 U/mL; it is a related marker for pancreatic cancer, gastric cancer, colorectal cancer, and gallbladder cancer.

CA15-3 (Carbohydrate Antigen 15-3)

Normal value: 0 ~ 32.4 U/mL; it is one of the indicators for auxiliary diagnosis of breast cancer (initial sensitivity 60%, late sensitivity 80%), postoperative follow-up and metastasis recurrence. Increases can also be seen in lung cancer, colon cancer, pancreatic cancer, ovarian cancer, and primary liver cancer.

SCC (Squamous Cell Carcinoma Antigen)

Normal value: < 1.5 ug/L; it is a tumor marker of squamous cell carcinoma, and can be used for auxiliary diagnosis, treatment observation and recurrence monitoring of cervical cancer, lung squamous cell carcinoma, esophageal cancer, head and neck cancer, and bladder cancer.

NSE (neuron-specific enolase)

Normal value: < 16.3 ng/mL; it is a tumor marker for small cell lung cancer (91% diagnostic positive rate), and can also be used for curative effect observation and recurrence monitoring. The serum NSE concentration of neuroblastoma and neuroendocrine cell tumors can also be significantly increased.

Lung cancer serum TM

Pro-GRP (progastrin releasing peptide fragment)

When it is greater than 24 ng/L, lung tumors are highly suspected, and the specificity for small cell lung cancer is very high, with a high positive rate in early cases (sensitivity up to 50.3%).

CYFRA21-1 (fragment of cytokeratin 19)

Broad-spectrum TM is an antigen associated with non-small cell lung cancer, and its sensitivity in diagnosing squamous cell carcinoma of the lung is as high as 93.8%. Dynamic monitoring of this indicator can be used to better observe changes in efficacy.

TRACP-5b (tartrate-resistant acid phosphatase 5b)

It is mainly derived from osteoclasts. When osteolytic injury occurs, TRACP-5b in the blood increases. Therefore, the level of serum TRACP-5b can be used to monitor the disease process of bone metastasis of malignant tumors such as lung cancer.

sB7-H3 (soluble B7-H3)

It is abnormally expressed in lung cancer, prostate cancer, cervical cancer, gastric cancer, etc. Through statistical analysis of the diagnostic efficacy of sB7-H3, CEA and CYFRA21-1 in lung cancer patients, CYFRA21-1 has the highest sensitivity and sB7-H3 has the highest specificity.

TuM2-PK (tumor M2-type pyruvate kinase)

Significantly increased TuM2-PK levels can indicate tumor progression in lung cancer patients, and the sensitivity of serum detection of non-small cell lung cancer is 71.64%.

HCC serum TM

AFP (alpha-fetoprotein)

The normal value is 0 ~ 8.1 ng/mL. In the case of excluding active liver disease, germinal embryonal tumor and pregnancy, serum quantitative determination of AFP > 400 ng/mL for four weeks, or > 200 ng/mL for eight weeks, can be diagnosed as primary HCC.

DCP ( abnormal prothrombin)

An abnormal prothrombin molecule plays an important role in the malignant proliferation of liver cells, and the sensitivity in the early diagnosis of liver cancer is as high as 77%.

GPC3 (Glypican-3)

Belonging to the proteoglycan family, because it can be detected in liver cancer cells but not in benign liver tissues, GPC3 has the potential to be used as a marker for the diagnosis of early liver cancer.

OPN (osteopontin)

It is a secreted phosphorylated glycoprotein with increased expression in liver cancer. It can also be overexpressed in other different types of malignant tumors, such as: lung cancer, breast cancer, colon.

GP73 (Golgi protein-73)

It is a Golgi transmembrane protein that can be detected in the serum of patients with liver diseases, especially liver cancer, and its level has nothing to do with the etiology of liver cirrhosis, liver function, and tumor diameter.

MMP1 (matrix metalloproteinase 1)

MMP1 can accurately distinguish the hepatocellular carcinoma with AEP level lower than 20 ng/mL, so MMP1 can be used as a biological marker for early diagnosis of hepatocellular carcinoma.

Gastric cancer serum TM


CA72-4 (carbohydrate antigen CA72-4)

The content in normal human serum is < 6 U/mL, and the abnormal increase is mainly seen in human adenocarcinoma tissue. It is currently recognized as a good tumor marker for the diagnosis of gastric cancer, and its specificity is better than that of CA19-9 and CEA.

MG7-AG (Human Gastric Cancer MG7 Antigen )

Serum MG7-AG content showed an increasing trend from superficial gastritis, gastric mucosal erosion and ulcer, atrophic gastritis/dysplasia to gastric cancer. The positive rate of gastric cancer was 51.61%, and the detection rate of early gastric cancer was relatively high.

PG (pepsinogen)

 It is an inactive precursor of pepsin in gastric juice. Too low PGⅠ and PGⅠ/PGⅡ needs to be vigilant for early gastric cancer. Serum PGⅠ, PGⅡ levels and their ratio have important reference significance for the curative effect and recurrence of gastric cancer patients.

CA 50 (Carbohydrate Antigen 50)

The detection level and positive rate in each gastric cancer showed an upward change, which was lower in the early and middle stages, but significantly increased in advanced patients. The elevated levels of tumor markers may have a certain relationship with the metastasis and spread of tumors.

Ovarian Cancer SerumTM

In addition to common tumor markers such as CA125, CA19-9, CEA, and AFP, there are the following markers:

HCG (chorionic gonadotropin)

HCG is mostly produced by tumors during non-pregnancy periods. β-HCG is the one with the highest sensitivity and specificity among various tumor markers, and it has diagnostic value for primary ovarian choriocarcinoma, embryonal carcinoma, and mixed germ cell tumors.

LDH (lactate dehydrogenase) 

The overall specificity is not strong, and it can only be used for the detection of epithelial ovarian cancer and germ cell tumors.

M-CSF (Macrophage Colony Stimulating Factor)

The specificity is not high, and it is related to the progress of the clinical condition, and it can still be used as a reference index for the clinical diagnosis and follow-up of ovarian cancer.

HE4 (Human Epididymis Protein 4)

Exist in a variety of tumor cells, including ovarian cancer, lung cancer, colon cancer, breast cancer, etc., all have increased expression of HE4, HE4 has high specificity in the detection of ovarian cancer, and can be used for early screening of ovarian cancer Check and diagnose.

Breast Cancer SerumTM

In addition to the above-mentioned CEA and CA15-3, there are the following indicators:

ER and PR (estrogen receptor and progesterone receptor)

Currently, ER and PR have been identified as biomarkers of breast cancer. ER- and PR-positive breast cancer patients are mostly effective in endocrine therapy, with high remission rate, low recurrence rate and good prognosis.

HER-2 (Human Epidermal Growth Factor Receptor-2)

Activation of HER-2 is common in human breast cancers and is usually expressed on hormone receptor negative cells. High expression of HER-2 is positively correlated with lymph node metastasis, tumor stage and poor prognosis, and negatively correlated with ER and PR. The higher the expression level, the worse the prognosis of the disease.

TPA (Tissue Polypeptide Antigen)

As an embryonic protein, it exists in the plasma membrane and cell body of tumor tissue. Studies have shown that the positive detection rate of TPA in patients with breast cancer metastasis can reach 86%, which is higher than that of CA15-3.
A class of transmembrane glycoproteins exists on the cell surface or in malignant tumor tissues in a soluble form, and can be used as a tumor marker to predict breast cancer metastasis.
VEGF (Vascular Endothelial Growth Factor)
Studies have shown that the expression of VEGF in breast cancer is significantly higher than that in normal breast tissue, and patients with high VEGF expression are prone to cancer cell metastasis and recurrence, which is of great significance in the treatment and prognosis of breast cancer.

Endometrial CancerTM

In addition to CA125, CA19-9, ER and PR, which can be used as relevant tumor markers for endometrial cancer, there are the following indicators:
MMSET (Histone Methyltransferase)
The expression of MMSET in endometrial cancer tissue is significantly higher than that in normal endometrial tissue, and its expression ratio also increases with the increase of endometrial cancer malignancy, which can be used as an independent risk factor in the occurrence and development of endometrial cancer factor.
Adipokin is related to the occurrence and development of many tumors, and is also a related factor of endometrial cancer. With the gradual thickening of endometrial tissue and the occurrence and development of endometrial cancer, the expression of adipokinin gradually increased.
It is a member of the mammalian 18 glycosyl hydrolase family, also known as human cartilage glycoprotein-39, which is highly expressed in various malignant tumor tissues and patient serum, such as breast cancer, colon cancer, cervical cancer, endometrium cancer, ovarian cancer, etc.

Colorectal Cance TM

In addition to highly sensitive CEA and carbohydrate antigens (CA19-9, CA72-4, CA125, etc.), there are:

Lectins DC-SIGN and DC-SIGNR

It is a type of specific receptor expressed on the surface of dendritic cells (DC), which has the potential for early diagnosis of colorectal cancer, and its expression in serum and tissue may affect the survival of colorectal cancer patients.

CHGA (human chromogranin A)

A protein secreted by neuroendocrine cells. Elevated levels can be used as effective markers of pancreatic neuroendocrine tumors, pheochromocytoma, or paraganglioma. The decreased expression of CHGA in early colorectal cancer tissues suggests that it may be a new tumor marker for the diagnosis of colorectal cancer.

Interleukin (IL)

IL-6 can be combined with CEA and CA19-9 to detect colorectal cancer and improve the positive rate of diagnosis; IL-35 is highly expressed in all colorectal cancer tissues, and its expression level is highly correlated with tumor malignancy and clinical stage; -38 correlated with the degree of tumor differentiation.

Prostate Cancer SerumTM

PSA (Prostate Cancer Specific Antigen)

With organ specificity, the detection rate of prostate cancer in early, asymptomatic and curable stages is significantly improved.

 F-PSA/T-PSA ratio

PSA includes total PSA (T-PSA) and free PSA (F-PSA). F-PSA and T-PSA can be combined detection, when F-PSA /T-PSA <0.16, may suggest prostate cancer.

Bladder Cancer TM

 BTA (bladder tumor antigen)

It is mainly a qualitative test, and the positive rate of BTA test is high. Some studies have shown that its sensitivity can reach 86.9%. Mirror detection means.

 NMP22 (nuclear matrix protein)

As a special member of the nuclear matrix protein family, it can be detected at a high level in malignant bladder tumor tissues, and is widely distributed in urothelial transitional epithelial cells. The expression level of NMP22 in malignant tumor tissues is about 70 times that of normal tissues .

 BLCA-4 (bladder cancer-specific nuclear matrix protein 4)

BLCA-4 has a high positive rate in malignant tumor tissues related to bladder cancer, but no positive results of BLCA-4 are seen in bladder urothelial tissues of normal people, so the increase of BLCA-4 in urine High is of great value for early screening and diagnosis of bladder cancer.

miRNA (microRNA)

The expression of miRNA is closely related to the occurrence of bladder cancer. Studies have found that miRNA-99a, miRNA-100, and miRNA-101 have higher expression levels in non-muscle-invasive bladder cancer, while miRNA-21, miRNA -373 was expressed at a higher level in muscle invasive bladder cancer.

survivin (survivin) and Caspase-3 (caspase)

In patients with bladder cancer, the overexpression of survivin is related to the occurrence and development of bladder cancer. Caspase-3 is an apoptosis factor. Overexpression of Survivin can directly or indirectly inhibit the normal expression of Caspase-3, resulting in the imbalance of normal apoptosis in the human body.
Ultimately lead to tumor development and metastasis, detection of survivin and Caspase-3 expression levels in bladder cancer tissue can be used as one of the means to judge the prognosis of bladder cancer patients after surgery.

Pituitary TumorTM

Ki-67 antigen
It is often highly expressed in invasive pituitary adenomas, and its expression is significantly correlated with the growth rate of pituitary adenomas. The range of Ki-67 expression helps to formulate treatment plans for pituitary adenomas and is recommended for routine examination.

Telomerase reverse transcriptase (TERT) promoter

Patients with pituitary adenomas may have TERT promoter mutations and methylation changes, and TERT promoter methylation may be a potential biomarker for predicting the progression and recurrence of pituitary adenomas.

MCM7 (minichromosome maintenance protein family)

The overexpression of MCM7 is closely related to the early progression and recurrence of pituitary adenoma. As a marker for judging the clinical prognosis of pituitary adenoma, MCM7 contains richer and more reliable information than Ki-67.

Melanoma TM


S100B is currently the most widely used biomarker molecule in malignant melanoma, especially metastatic melanoma.  Elevated S100B levels are associated with prognosis, and elevated serum S100B levels strongly suggest poor prognosis.

MIA (Melanoma Activity Inhibitor Protein)

It is an autocrine tumor growth suppressor isolated from malignant melanoma cell line HTZ-19.  It is highly expressed in malignant melanoma cells and mostly not expressed in keratinocytes and skin tumors of non-melanoma origin.

Osteosarcom TM


ALP (alkaline phosphatase)

ALP is one of the members of the metalloenzyme family and plays an important role in the diagnosis of osteosarcoma or in predicting the prognosis of patients with osteosarcoma.
PS: Continuous observation of tumor markers is more meaningful, and a sudden increase is worth noting. 
When TM is elevated, it cannot be easily diagnosed as a malignant tumor, and it needs to be combined with other relevant examinations, clinical symptoms, physical examination and other comprehensive judgments.











The most comprehensive interpretation of 49 tumor markers

(source:internet, reference only)

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Important Note: The information provided is for informational purposes only and should not be considered as medical advice.