Biochemistry cancer
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Transcript of Biochemistry cancer
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Cancer Biochemistry
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Tumour marker
• Any substance that can be related to the presence or progress of a tumour.
• Hormones: human gonadotrophin (HCG) secreted by choriocarcinoma
• Enzymes: prostate specific antigen (PSA) in prostate carcinoma
• Tumour antigens: carcinoembryonic antigen (CEA) in colorectal carcinoma
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The use of tumour markers
Monitoring treatment• Surgery, chemotherapy, radiotherapy
Assessing follow-up• To monitor the marker long after the levels have
appeared to stabilized
Diagnosis• Detection in blood, biopsy
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Prognosis• To be of value in prognosis, the
concentration of the tumour marker in plasma should be correlate with tumour mass.
• Eg: HCG correlates well with the tumour mass in choriocarcinoma
• HCG and AFP correlate with the tumour mass in testicular teratoma
• Paraproteins correlate with the tumour mass in multiple myeloma.
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Screening for the presence of disease• Specific high-risk population• Eg: hormone calcitonin, which is
increased in all patients with medullary carcinoma of thyroid, may be used to screen close relatives.
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The important tumour markers:
• Alkaline phosphatase (ALP)• Lactate dehydrogenase (LDH)• Prostatic acid phosphatase (PAP)• Prostate specific antigen (PSA)• Human chorionic gonadotropin (HCG)• Alpha-fetoprotein (AFP)• Carcino-embryonic antigen (CEA)
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• CA-15 : marker for breast carcinomas• CA-125 : marker for ovarian and
endometrial carcinoma• Calcitonin (secreted by cells of thyroid
gland. Increased in medullary tumour of thyroid gland)
*carcinoma: cancer arising from epithelial tissue.
sarcoma: cancer from connective tissue
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• ALP- Primary or secondary liver cancer- Secondary bone cancer- Lung cancer- Cancer of GIT and ovary- Hodgkin’s disease
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• PAP-malignant conditions: cancer of prostate,
multiple myeloma, osteogenic sarcoma.-benign conditions: prostatic hypertrophy
(BPH) or enlarged prostate, osteoporosis and hyperparathyroidism.
• PSA-superior marker for prostatic cancer.
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• Human Chorionic Gonadotropin (HCG)-placental hormon. Synthesized by
syncytiotrophoblastic cells of placental villi.-choriocarcinoma. About 50% of cases of
choriocarcinoma follow hydatidiform mole pregnancy and HCG is used to screen these women.
-ideal tumour marker for diagnosing and monitoring gestational trophoblastic tumours and germ cell tumours of testes and ovary.
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• Alpha-Feto Protein (AFP)-like CEA, AFP is another oncofetal antigen.
AFT is synthesized in liver, yolk sac and GI tract in fetal life and released into serum of fetus.
-AFP is the more specific and ideal tumour marker for primary carcinoma of the liver (hepatocellular carcinoma)
-serum AFP and HCG are best available tumour markers for germ cell type of tumours.
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• Cancer antigen 125 (CA-125)-used for screening and diagnosis of ovarian
carcinoma-not specific for ovarian carcinoma
• CA 15-3 & CA-27.29- useful as tumour marker in breast carcinoma
• CA 19-9-useful as tumour marker in pancreatic cancer
and biliary tract cancers.
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Hormones
• produced by many tumors• natural product or represent abnormal
synthesis• eg: insulin by islet cell tumor, calcitonin by
medullary thyroid carcinoma, catecholamines by pheochromocytoma
• ectopic hormones - ACTH and ADH by lung cancer