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SPECIFIC TUMOR MARKERS( Enzymes is the first markers)1

SPECIFIC  TUMOR MARKERS 

We'll talk in details about of specific tumor markers 

the first is the enzymes with their examples ( the first marker ) 



ENZYMES 

Enzymes may have been the first markers used in screening for cancer . 
Although the elevations of an enzymes is never specific for cancer , a routine chemistry profiles often includes the enzymes : 
Lactate dehydrogenase and alkaline phosphatase and may include creatine kinase , amylase , or gamma glutamyltransferase  .Each of these enzymes may be elevated in one or more forms of cancer . 


Other enzymes are more specific for cancer these includes : 
The collagenase , cathepsin , D. the protease secreted by malignant cells to break down surroundings tissue being invaded by the tumor . 

Acid phosphatase (ACP) 

Acid phosphatase levels increased in : 
1 - Some patients with prostatic  adenocarcinoma . 
2 - In patients with benign prostatic hyperplasia 
3 - Elevation level of serum prostatic acid phosphatase may be seen in malignant conditions such as osteogenic sarcoma , multiple myeloma and bone metastases of other cancer . 
4 - It also elevated in benign conditions such as osteoporosis and hyper-parathyroid-ism


Alkaline  phosphatase (ALP) 

Elevation of ALP correlates well with osteoblastic activity and can be used to monitor therapy and look for recurrence in patients with osteosarcoma  . 
ALP is used to differentiate bone and liver malignancy 


Creatine kinase 

The BB isoenzyme , commonly known as the brain fraction , is associated with many malignant disease . 
Elevations of creatine kinase -BB (CK-BB)   may shown in malignancy in the lungs . prostate , breast , ovary , kidney , bladder and brain . 


Lactate dehydrogenase (LD) 

Lactate dehydrogenase ( LD)  is nonspecific marker . There is no constant  isoenzymes pattern associated with malignancy but non specific elevation of fraction 2,3and 4 is common and called the malignant pattern . 
Benign of malignant tumors shows an increased level of LD, which correlates well with the growth rate of the tumor . 
Elevation of LD are seen in tumors of the colon , breast , lung , liver and in leukemia and lymphomas  . 


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