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

CEATHE SRUM CONCENTERATION CORRELATES WELL WITH TUMOR ACTIVITY & CAN BE USED TO PREDICT PROGNOSISNOT SUITABLE FOR SCREENIGDON’T APPER SUFFICIENTLY EARLYLOW POSITIVE PREDICTIVE VALUEADJUNCT TESTEXTREMELY & USEFUL FOR MONITORING THE SUCCESS OF TREATMENT & FOR DETECTING RECURRENCEASSOCIATION 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 (