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
