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OF COLOREATAL CANCER USING SEROLOGIC TUMOR MARKERS DIAGNOSIS & MANAGEMENT.

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Presentation on theme: "OF COLOREATAL CANCER USING SEROLOGIC TUMOR MARKERS DIAGNOSIS & MANAGEMENT."— Presentation transcript:

1 OF COLOREATAL CANCER USING SEROLOGIC TUMOR MARKERS DIAGNOSIS & MANAGEMENT

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

3 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

4 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)

5 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

6 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

7 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

8 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

9 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

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

11 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

12 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)


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