1. EKUSILENI CLINICAL LABORATORY
PSA AND CEA AS SURROGATE MARKERS FOR CANCER DIAGNOSIS
TALENTS MURAHWA
(BIOMEDICAL SCIENTIST)

2. LAB & CANCER MANAGEMENT What are tumor markers
Definition: -
A tumour marker is a biochemical indicator selectively produced by the neoplastic tissue and released into blood and detected in blood or in other body fluids.
It may be used to: -
Detect the presence of a tumour
Monitor the progress of disease
Monitor the response to treatment
2007
EKUSILENI CLINICAL LABORATORY

3. Tumour Markers: - Classification
Class 1: Antigens unique to a neoplasm not shared by other tumours of same histological type .
Class 2: Antigens expressed by many or most tumours of a specific histological type and of other histological type,
But not expressed by normal adult tissue.
Class 3: Antigens expressed by both cancer and normal adult tissue.
2007
EKUSILENI CLINICAL LABORATORY

4. NATURE OF TUMOUR MARKERS
1.Oncofetal antigens
Alpha Feto Protein
CEA
Pancreatic Oncofoetal Antigen
2.Proteins
Casein – By breast carcinoma
Ferritin- Leukaemia
3.Enzymes
Creatinekinase – Prostate tumour
Alkaline Phosphatase – Lungs tumour
Acid Phosphatase – Prostate tumour
2007
EKUSILENI CLINICAL LABORATORY

5. EKUSILENI CLINICAL LABORATORY
Receptors
Oestrogen, Progesterone, Androgen
Polyamines
Spermine, Spermidine, Putridine – leukemia, lymphoma, colorectal CA
Cell Markers
T cell marker, B cell marker-lymphoma
Ectopic Hormones
HCG, GH, Erythropoetin, Renin
2007
EKUSILENI CLINICAL LABORATORY

6. EKUSILENI CLINICAL LABORATORY
LOCAL LABORATORY TESTS ON OFFER
1.Alfa Feto Protein
2.CEA
3.PSA
ALPHA AMYLASE
LDH
2007
EKUSILENI CLINICAL LABORATORY

7. EKUSILENI CLINICAL LABORATORY
Alfa Feto Protein:-
Measurement of maternal serum and amniotic fluid levels play an important role in the screening for
Foetal neural tube defects
Chromosomal abnormalities including Down’s Syndrome.
Most measurements are done at 16 weeks of gestation.
Raised maternal serum AFP levels are not specific for neural tube defects.
Must be used in combination with other modalities such as USG, amniotic fluid AFP and acetylcholine esterase.
2007
EKUSILENI CLINICAL LABORATORY

8. EKUSILENI CLINICAL LABORATORY
Alfa Feto Protein:-
Many fetal conditions are associated with abnormal maternal serum AFP levels.
Elevated:
NTD, GI obstruction, Liver necrosis, Abdominal wall defects (Omphalocele, Gastroschisis), Sacrococcygeal tumour, Cystic hygroma, IUGR, multiple pregnancies, renal anmalies.
Low:
Chromosomal trisomies (Down’s syndrome), Gestational trophoblastic diseae, IUD, placental defects, GA underestimated, Foetal distress, Hydrops Foetalis, TOF, Cyclopia.
2007
EKUSILENI CLINICAL LABORATORY

9. EKUSILENI CLINICAL LABORATORY
Alfa Feto Protein:-
After birth AFP usually falls, within 8 to 12 months of delivery to a very low conc.of 10mcg/ml and persists at this low level throughout life.
Unexplained and persistent elevation of AFP in nonpregnant state should be screened, as it may be due to-
Hepatocellular Ca, germ cell tumour, hereditary persistence of AFP, viral hepatitis and cirrhosis .
In addition to its role in prenatal diagnosis, it is also widely used in the diagnosis, therapeutic monitoring and follow up of patients in germ cell tumours.
2007
EKUSILENI CLINICAL LABORATORY

10. Germ Cell Tumours Producing AFP
Dysgerminoma
Endodermal Sinus tumour / +
yolk sac tumour
Immature tetratoma /-
4. Mixed germ cell tumour +/-
5. Choreocarcinoma
6. Embryonal CA
2007
EKUSILENI CLINICAL LABORATORY

11. EKUSILENI CLINICAL LABORATORY
CEA:-
It is a glycoprotein of mol.wt 200kda.
Though it is a tumour marker for GI cancers, it is also expressed by
malignant mucinous tumor (100%),
100% cases of atypical hyperplasia of endometrium,
60% cases of endometrial Ca,
50-80% cases of squamous cell of Cx,
75-100% cases of adenocarcinoma of Cx.
It is also produced in pneumonia, hypothyroidism and pancreatic tumours.
2007
EKUSILENI CLINICAL LABORATORY

12. EKUSILENI CLINICAL LABORATORY
PSA
Prostate-Specific Antigen (PSA)
A prostate-specific antigen (PSA) test measures the amount of prostate-specific antigen in the blood. PSA is released into a man's blood by his prostate gland.
2007
EKUSILENI CLINICAL LABORATORY

13. EKUSILENI CLINICAL LABORATORY
Healthy men have low amounts of PSA in the blood. The amount of PSA in the blood normally increases as a man's prostate enlarges with age. PSA may increase as a result of an injury, a digital rectal exam, sexual activity (ejaculation), inflammation of the prostate gland ( prostatitis), or prostate cancer
2007
EKUSILENI CLINICAL LABORATORY

14. EKUSILENI CLINICAL LABORATORY
PSA Why is it done?
Why It Is Done
The prostate-specific antigen (PSA) test is done to:
Monitor prostate cancer and how it responds to treatment. If PSA levels increase, the cancer may be growing or spreading. PSA is usually not present in a man who has had his prostate gland removed. A PSA level that rises after prostate removal may mean the cancer has returned or has spread.
2007
EKUSILENI CLINICAL LABORATORY

15. EKUSILENI CLINICAL LABORATORY
PSA
Prostate cancer often grows very slowly, without causing major problems. Detecting prostate cancer early and treating it may prevent some health problems and reduce the risk of dying from the cancer. However, some treatments for prostate cancer can cause other problems, such as
2007
EKUSILENI CLINICAL LABORATORY

16. EKUSILENI CLINICAL LABORATORY
PSA
Determine if cancer may be present when other tests, such as a digital rectal exam, are not normal. A PSA test does not diagnose cancer, but it can be used along with other tests to determine if cancer is present.
2007
EKUSILENI CLINICAL LABORATORY

17. EKUSILENI CLINICAL LABORATORY
PSA
Check men for prostate cancer. Experts disagree on the usefulness of PSA testing as a screening tool for prostate cancer. If a PSA test is used for screening, it is usually done for men older than age 50 or for those at high risk for prostate cancer, such as men with a family history of prostate cancer, or for African-American men who have a higher chance of developing cancer than other men. Since other common medical conditions, such as prostatitis, can cause high PSA levels, a prostate biopsy is needed to confirm a diagnosis of cancer.
2007
EKUSILENI CLINICAL LABORATORY

18. EKUSILENI CLINICAL LABORATORY
CONCLUSION TM cannot be NECESSARILY constructed as primary modalities for diagnosis of tumours THANK YOU
2007
EKUSILENI CLINICAL LABORATORY