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Tumor Markers Questions and Answers Graded A+
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Exam of 8 pages for the course cancer at cancer (Tumor Markers)
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Tumor MarkersWhich of the following tumor markers is classified as a tumor suppressor gene?
A. BRCA-1
B. Carcinoembryonic antigen (CEA)
C. Human chorionic gonadotropin (hCG)
D. Nuclear matrix protein - answerA
Tumor markers may be enzymes, hormones, receptors, oncofetal (glycoprotein)
antigens, or oncogenes. BRCA-1 is located on the long arm of chromosome 17 and
carries an 85% lifetime risk of breast or ovarian cancer when present. Its product
functions in DNA repair and slows cell proliferation.
Harr, Robert R. Medical Laboratory Science Review (Page 304). F.A. Davis Company.
Kindle Edition.
In general, in which of the following situations is the analysis of a tumor marker most
useful?
A. Testing for recurrence
B. Prognosis
C. Screening
D. Diagnosis - answerA
Most tumor markers are expressed at very low levels so that the concentration in early
malignancy overlaps that seen in normal individuals. This makes them ineffective for
screening. Three exceptions are hCG in males for testicular cancer, calcitonin for
thyroid medullary cancer, and prostate-specific antigen (PSA) for prostate cancer. Most
tumor markers are increased in nonmalignant disease, and this nonspecificity reduces
their usefulness for diagnosis of malignancy. In addition to the three markers
mentioned, the hormones insulin (insulinoma), gastrin (gastrinoma), and prolactin
(prolactinoma), and the catecholamines (pheochromocytoma) have some diagnostic
utility. Some tumor markers are useful predictors of disease progression and response
to treatment. These include BRCA-1, estrogen and progesterone receptors, cathepsin-
D, and the Philadelphia chromosome. The major use of tumor markers is to monitor
recurrence and therapy. Successful treatment reduces the concentration of the marker
significantly or results in an undetectable level. A rise in level following treatment signals
recurrence.
Harr, Robert R. Medical Laboratory Science Review (Page 304). F.A. Davis Company.
Kindle Edition.
Which of the following enzymes is increased in persons with prostate and small-cell
lung cancer?
A. Creatine kinase-1 (CK-1)
, B. Gamma glutamyl transferase (GGT)
C. Amylase
D. Lactate dehydrogenase - answerA
CK-1 (CK-BB) is not normally found in plasma or serum except in neonates. It may be
present in persons with central nervous system damage and some other disorders but
its presence is often associated with various malignancies, especially prostate cancer
and small-cell carcinoma of the lung. Several other commonly measured enzymes are
elevated by malignancy. ALP and LD are associated with various tumors. GGT levels
are very high in hepatoma, and amylase is elevated in pancreatic cancer.
Harr, Robert R. Medical Laboratory Science Review (Page 304). F.A. Davis Company.
Kindle Edition.
Which of the following is the best analyte to monitor for recurrence of ovarian cancer?
A. CA-15-3
B. CA-19-9
C. CA-125
D. CEA - answerC
CA-125 is an oncofetal antigen, meaning that it is produced by genes that are active
during fetal development but minimally active after birth except in malignant tissues.
This group includes α-fetoprotein (AFP), CEA, PSA, and the carbohydrate-associated
antigens (CA). CA-15-3 (which shares the same antigenic determinant as CA-27.29) is
used mainly to monitor breast cancer treatment and recurrence. CA-19-9 (which shares
the same antigenic determinant as CA-50) is a glycoprotein shed from the surface of
gastric, pancreatic, and colorectal cancer cells.
Harr, Robert R. Medical Laboratory Science Review (Page 305). F.A. Davis Company.
Kindle Edition.
Which tumor marker is associated with cancer of the urinary bladder?
A. CA-19-9
B. CA-72-4
C. Nuclear matrix protein
D. Cathepsin-D - answerC
Nuclear matrix proteins (NMPs) are RNA-protein complexes. NMP-22 is shed into the
urine in persons with bladder carcinoma and is about 25-fold higher than normal in this
condition. It has a clinical sensitivity of about 70% but is likely to be negative when the
tumor is low grade. Other markers used for detection of bladder cancer include bladder
tumor associated analytes (BTAs), a variant of the complement factor H protein;
cytokeratin-20, a variant cytokeratin (fibrous protein) in the cytoplasm of malignant
bladder epithelium; and telomerase, an enzyme that adds nucleotides to the ends of
chromosomes, preventing telomere degradation. The specificity of these tests varies
from approximately 75%-80%. Bladder cancer can also be detected by FISH because it
is associated with a high incidence of ploidy and other chromosomal abnormalities that
can be detected by fluorescent-labeled DNA probes. FISH specificity is over 94%, and
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