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 .