OF COLOREATAL CANCER USING SEROLOGIC TUMOR MARKERS DIAGNOSIS & MANAGEMENT

BODY FLUID TUMOR MARKERS: 1- TUMOR-ASSOCIATED PROTEINS (ONCOFETAL ANTIGENS) 2-ONCOPROTEINS 3-PROTEOMICS

IDEALLY, A TUMOR MARKER WOULD BE: 1-TUMOR SPECIFIC 2-ABSENT IN HEALTHY INDIVIDUALS 3-READILY DETECTABLE IN BODY FLUIDS 4-ELEVATE AT AN EARLY CANCER STAGE

A HOST OF T.M. HAVE A HIGH ENOUGH SPECIFICITY & SENSITIVITY TO BE USED IN: 1-SCREENING POPULATION AT RISK & DIAGNOSIS 2-PROGNOSIS OF RECURRENCE & MONITORING 3-DETECTION RESPONSE TO TREATMENT (CEA)

OF SERUM TESTING OVER TISSUE ADVENTAGES BASED METHODS 1-IMPROVED SENCITIVITIES OF THE ASSAYS 2-IMPROVEMENT OF INSTRUMENTATION 3-NONINVASIVE NATURE 4-MORE ACCURATE QUANTIFICATION 5-LAKE OF INTER-OBSERVER DIFFERENCE

CEA THE SRUM CONCENTERATION CORRELATES WELL WITH TUMOR ACTIVITY & CAN BE USED TO PREDICT PROGNOSIS NOT SUITABLE FOR SCREENIG DON’T APPER SUFFICIENTLY EARLY LOW POSITIVE PREDICTIVE VALUE ADJUNCT TEST EXTREMELY & USEFUL FOR MONITORING THE SUCCESS OF TREATMENT & FOR DETECTING RECURRENCE ASSOCIATION BETWEEN HIGHLY ELEVATED CEA & METASTASIS & POOR PROGNOSIS

RECOMMENDATION FOR ORDERING TUMOR MARKER TESTS NEVER RELY ON THE RESULT OF A SINGLE TEST WHEN ORDERING SERIAL TESTING, BE CERTAIN TO ORDER EVERY TEST FROM THE SAME LAB USSING THE SAME ASSAY KIT

BE CERTAIN THAT THE T.M. SELECTED FOR MONITORING RECURRENCE WAS ELEVATED IN PATIENT PRIOR TO SURGERY CONSIDER THE HALF-TIME OF THE T.M. & HOW IT IS REMOVED OR METABOLIZED WHEN INTERPRETING THE TEST RESULT

CONSIDER ORDERING MULTIPLE MARKERS TO IMPROVE BOTH THE SENSITIVITY & SPECIFICITY FOR DIAGNOSIS MAB-DEFINED T.M. ( CEA,CA19-9, CA15-3, CA125) CA15-3, CA72-4,CA125 CEA, CA19-9,CA 72-4 (CA19-5,NSE, CHROMOGRANIN A,CA50 BE AWARE OF THE PRESENCE OF ECTOPIC T.M. HETEROPHILIC Abs

ELEVATED SERUM VEGF 1-BREAST, OVARIAN, HEPATOCELLULAR, COLORECTAL & RENAL CELL CARCINOMAS & SOFT TISSUE SARCOMA 2-SHORTER SURVIVAL IN COLON CARCINOMA, RCC, OVARIAN CARCINOMA

ONCOPROTEINS&EARLY DETECTION OF COLORECTAL CANCER TGF-A(AT AN EARLY STAGE) RAS ONCOPROTEIN P21(75% OF COLON CANCER) P185 ERB 2 ECD(NEU) PROTEIN,COLORECTAL TUMOR SIZE PROGRESSION MUTANT P53 PROTEIN(1/5 CARCINOMA,1/10 ADENOMA,ELIZA) CIRCULATING ANTI-P53 Abs(15%) C-MYC-RELATED P40 PROTEIN ANTI-MYC Ab NUCLEAR MATRIX PROTEIN

DIRECTION FOR THE FUTURE SERUM GENOMICS&PROTEOMICS ASPOTENTIAL BIOMARKERS FOR CANCER NEW MOLECULAR TECHNIQUES IN DETECTING CIRCULATING DNA&RNA CIRCULATING TUMOR CELLS IN PERIPHERAL BLOOD (RECURRENCE,METASTASIS,SENSITIVITY TO CHEMOTHERAPY)