Tumor marker tests
What is a tumor marker?
Tumor markers are substances that can be detected in higher than normal amounts in the blood, urine, or body tissues of some people with certain types of cancer.
How does a tumor marker develop?
A tumor marker may be produced by the tumor itself, or by the body in response to a cancer presence.
Why are tumor markers tested?
When diagnosing cancer, blood and pieces of tumor tissue are tested. These tests help to determine the characteristics of the tumor (aggressiveness, rate of growth, and degree of abnormality). Tests for tumor markers may be used with other tests or x-rays to detect and diagnose some cancers.
What can tumor markers be?
Tumor markers may be proteins, antigens, or hormones. Tumor marker tests are not used alone in diagnosis because most markers can be found in elevated levels in people who have benign conditions, and because no tumor marker is specific to a particular cancer.
Not every tumor will cause an elevation in the tumor marker test, especially in the early stages of cancer. Physicians can use changes in tumor marker levels to follow the course of the disease, to measure the effect of treatment, and to check for recurrence.
Tumor markers for specific types of cancer
Listed on the next page are several different tumor markers for certain types of cancer. They are listed in alphabetical order.
Certain tumor markers are simply more accurate than others in their sensitivity to detection of cancer. The more sensitive they are, the earlier it is possible to diagnose. Normal levels differ between people and between laboratories. The values listed on the chart are the normals established at The University of Iowa Hospitals & Clinics. Your physician is the best person to consult if you have concerns about your specific test level.
| ml: | milliliter | U: | International Unit |
| ng: | nanogram | >: | greater than |
| pg: | picogram | <: | less than |
| ug: | microgram | < | less than or equal to |
| u/l: | units per liter |
| Tumor Marker | Primary Cancer Site | Secondary Cancer Site (>50%) | False Positives | Other Benign Diseases Detected | Normal Values |
|---|---|---|---|---|---|
| Antidiuretic Hormone (ADH) | Small cell lung cancer, adenocarcinoma | Inappropriate secretion assoc. w/pneumonia | Porphyria-a group of disorders of porphryrin metabolism which effects blood and liver | 1-5 pg/ml | |
| Alpha-feto protein (AFP) | Liver, germ cell cancer of ovaries or testis | Stomach | Pregnancy | Cirrhosis, hepatitis, toxic liver injury, inflammatory bowel disease, ataxia telangiectasia, Wiscott-Aldrich Syndrome | 0-6.4 IU/ml in men and nonpregnant women |
| BTA (Bladder Tumor Antigen) | Bladder | Recent invasive procedure, Infection genitourinary tract, Cancer of kidney, ureters | Not detected | ||
| CA15-3 (carbohydrate antigen 15-3) | Breast | Often not elevated in early stages of breast cancer | benign breast & liver cancer | < 31 U/ml | |
| CA19-9 | Pancreas, colorectal | pancreatitis, ulcerative colitis, inflammatory bowel disease | < 33 U/ml | ||
| CA125 | Ovarian | Breast, colorectal, uterus, cervix, pancreas, liver, lung | Pregnancy, Menstration | Endometriosis, ovarian cysts, fibroids, cirrhosis, peritonitis, pancreatitis, pleural effusion, pelvic inflammatory disease | 0-35 U/ml |
| Calcitonin | Thyroid medullary carcinoma | Ectopic calcitonin-producing tumors (rare) | Basal: < 0.155 ng/ml for men< 0.105 ng/ml for women | ||
| Carcinoembryonic antigen (CEA) | Colon | Kidney, thyroid, liver, lymphoma, lung, stomach, melanoma, bladder, ovary, cervix, breast, pancreas, stomach, bladder | Cigarette smokingAbout 5% of the population has above normal CEA | pancreatitis, hepatitis, COPD, lung infection, inflammatory bowel disease, biliary obstruction | < 3 ng/ml in non-smokers < 5 ng/ml in smokers |
| Creatin-kinase-CK | Breast, ovary, colon, prostate | renal failure, bowel infarction, stroke | 40-200 u/l in men 35-150 u/l in women | ||
| hCG (human chorionic gonadotropin) | Trophoblastic disease, Choriocarcinoma | Germ cell tumors | Pregnancy, marijuana smoking, testicular failure | duodenal ulcers, cirrhosis, inflammatory bowel disease, benign breast, lung, pancreas, ovary, or GI cancer | > 31 IU/ml |
| Her2neu (cerbB2) | Breast | No "normal". The test is to determine if the tissue over expresses her2heu. | |||
| Lactic dehydrogenase (LDH) | Lymphoma, seminoma, acute leukemia, metastatic carcinoma | hepatitis, myocardial infarction | 100-210 u/l | ||
| Neuron-specific enolase (NSE) | Neuroblastoma, small cell lung cancer | < 13 ng/ml | |||
| NMP 22 | Bladder | Recent invasive procedure, Chemotherapy, Infection of genitourinary tract, Benign genitourinary disease, renal or bladder stones | < 10 | ||
| Prostatic acid phosphatase (PAP) | Metastatic cancer of prostate, myeloma, lung cancer, osteo-genic sarcoma | Testicular, leukemia and non-Hodgkin's lymphoma | prostatitis, nodular prostatic hypertrophy, Gaucher's disease, osteoporosis, cirrhosis of the liver, pulmonary embolism hyperparathyroidism | 0.5-1.9 u/l | |
| Prostate specific antigen (PSA) | Prostate | benign prostatic hypertrophy, nodular prostatic hyperplasia, prostatitis | < 4 ng/ml |