First Aid p. 232, Serum tumor markers and psammoma bodies

P-glycoprotein

Classically seen in adrenal cell carcinoma but also in other cancer cells. Used to pump out toxins, including chemo

Psammoma bodies

Laminated, concentric spherules with dystrophic calcification

Calcitonin

Medullary thyroid carcinoma.

Alkaline phosphatase

Metastases to bone or liver, Paget disease of bone, seminoma

Chromogranin

Neuroendocrine tumors/carcinoid.

AFP

low levels associated with Down syndrome

*P*apillary carcinoma of thyroid, *S*erous papillary cystadenocarcinoma of ovary, *M*eningioma, *M*alignant mesothelioma (PSaMMoma)

name the 4 cancers that have psammoma bodies

AFP

high levels associated with neural tube and abdominal wall defects

CA 15-3/CA 27-29

Breast cancer.

AFP

Hepatocellular carcinoma, hepatoblastoma, yolk sac (endodermal sinus) tumor, mixed germ cell tumor.

hCG

Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease), testicular cancer, mixed germ cell tumor.

AFP

Normally made by fetus. Transiently elevated in pregnancy

CA 125

Ovarian cancer.

CA 19-9

Pancreatic adenocarcinoma.

hCG

Produced by syncytiotrophoblasts of the placenta.

PSA

Prostate cancer. Can also be elevated in BPH and prostatitis. Questionable risk/benefit for screening.

CEA

Very nonspecific but produced by ∼ 70% of colorectal and pancreatic cancers; also produced by gastric, breast, and medullary thyroid carcinomas

P-glycoprotein

aka multidrug resistance protein 1

TNF, IFN-gamma, IL-1, IL-6

cachexia is mediated by these 4 cytokines