Tumor marker

Not to be confused with Cancer biomarker.

Proxy markers for certain cancers

A tumor marker is a biomarker that can be used to indicate the presence of cancer or the behavior of cancers (measure progression or response to therapy). They can be found in bodily fluids or tissue. Markers can help with assessing prognosis, surveilling patients after surgical removal of tumors, and even predicting drug-response and monitor therapy.[1]

Tumor markers can be molecules that are produced in higher amounts by cancer cells than normal cells, but can also be produced by other cells from a reaction with the cancer.[2]

The markers can't be used to give patients a diagnosis but can be compared with the result of other tests like biopsy or imaging.[2]

## Classification

[edit]

Tumor markers can be proteins, carbohydrates, receptors and gene products. Proteins include hormones and enzymes. To detect enzyme tumor markers enzyme activity is measured. They were previously widely used, but they have largely been replaced by oncofetal antigens and monoclonal antibodies, due to disadvantages such as most of them lacking organ specificity. Carbohydrates consists of antigens on and/or secreted from tumor cells, these are either high-molecular weight mucins or blood group antigens. Receptors are used to determine prognosis and measure how the patient responds to treatment, while genes or gene product can be analyzed to identify mutations in the genome or altered gene expression.[citation needed]

## Uses

[edit]

Tumor markers may be used for the following purposes:

* Monitoring the malignancy

When a malignant tumor is found by the presence of a tumor marker, the level of marker found in the body can be monitored to determine the state of the tumor and how it responds to treatment. If the quantity stays the same during treatment it can indicate that the treatment isn't working, and an alternative treatment should be considered. Rising levels of tumor marker does not necessarily reflect a growing malignancy but can result from things like unrelated illnesses.

* Reflect the stage of cancer

By determining the stage of cancer, it's possible to give a prognosis and treatment plan.[3]

* Screening for cancers

No screening test is wholly specific, and a high level of tumor marker can still be found in benign tumors. The only tumor marker currently used in screening is PSA (prostate-specific antigen).

* Diagnostics

Tumor markers alone can't be used for diagnostic purposes, due to lack of sensitivity and specificity.[4] The only approved diagnostic method for cancer is with a biopsy.

* Detects reoccurring cancers

Tumor markers can detect reoccurring cancers in patients post-treatment.[3]

## Techniques

[edit]

Tumor markers can be determined in serum or rarely in urine or other body fluids, often by immunoassay, ⁣⁣ but other techniques such as enzyme activity determination are sometimes used. Assaying tumor markers were significantly improved after the creation of ELISA and RIA techniques and the advancement of monoclonal antibodies in the 1960s and 1970s.[2]

For many assays, different assay techniques are available. It is important that the same assay is used, as the results from different assays are generally not comparable. For example, mutations of the p53 gene can be detected through immunohistochemical polymorphism screening of DNA, sequence analysis of DNA, or by single-strand conformational polymorphism screening of DNA. Each assay may give different results of the clinical value of the p53 mutations as a prognostic factor.[5]

Interlaboratory proficiency testing for tumor marker tests, and for clinical tests more generally, is routine in Europe and an emerging field[6] in the United States. New York state is prominent in advocating such research.[7]

## List of commonly used markers

[edit]

Tumor marker | Associated tumor types

|

Alpha fetoprotein (AFP) | germ cell tumor, hepatocellular carcinoma[8]
CA15-3 | breast cancer[9]
CA27.29 | breast cancer[10]
CA19-9 | Mainly pancreatic cancer, but also colorectal cancer and other types of gastrointestinal cancer.[11]
CA-125 | Mainly ovarian cancer,[12] but may also be elevated in for example endometrial cancer, fallopian tube cancer, lung cancer, breast cancer and gastrointestinal cancer.[13]
Calcitonin | medullary thyroid carcinoma[14]
Calretinin | mesothelioma, sex cord-gonadal stromal tumor, adrenocortical carcinoma, synovial sarcoma[8]
Carcinoembryonic antigen (CEA) | gastrointestinal cancer, cervix cancer, lung cancer, ovarian cancer, breast cancer, urinary tract cancer[8]
CD34 | hemangiopericytoma/solitary fibrous tumor, pleomorphic lipoma, gastrointestinal stromal tumor, dermatofibrosarcoma protuberans[8]
CD99 | Ewing sarcoma, primitive neuroectodermal tumor, hemangiopericytoma/solitary fibrous tumor, synovial sarcoma, lymphoma, leukemia, sex cord-gonadal stromal tumor[8]
CD117 | gastrointestinal stromal tumor, mastocytosis, seminoma[8]
Chromogranin | neuroendocrine tumor[8]
Chromosomes 3, 7, 17, and 9p21 | bladder cancer[15]
Cytokeratin | Many types of carcinoma, some types of sarcoma[8]
Desmin | smooth muscle sarcoma, skeletal muscle sarcoma, endometrial stromal sarcoma[8]
Epithelial membrane antigen (EMA) | many types of carcinoma, meningioma, some types of sarcoma[8]
Factor VIII; CD31, FL1, CD34 | vascular sarcoma[8]
Glial fibrillary acidic protein  (GFAP) | glioma (astrocytoma, ependymoma)[8]
Gross cystic disease fluid protein (GCDFP-15) | breast cancer, ovarian cancer, salivary gland cancer[8]
HMB-45 | melanoma, PEComa (for example angiomyolipoma), clear cell carcinoma, adrenocortical carcinoma[8]
Human chorionic gonadotropin (hCG) | gestational trophoblastic disease, germ cell tumor, choriocarcinoma[8]
immunoglobulin | lymphoma, leukemia[8]
inhibin | sex cord-gonadal stromal tumor, adrenocortical carcinoma, hemangioblastoma[8]
keratin (various types) | carcinoma, some types of sarcoma[8]
lymphocyte marker (various types) | lymphoma, leukemia[8]
MART-1 (Melan-A) | melanoma, steroid-producing tumors (adrenocortical carcinoma, gonadal tumor)[8]
Myo D1 | rhabdomyosarcoma, small-blue-round-cell tumor[8]
muscle-specific actin (MSA) | myosarcoma (leiomyosarcoma, rhabdomyosarcoma)[8]
neurofilament | neuroendocrine tumor; small-cell carcinoma of the lung[8]
neuron-specific enolase (NSE) | neuroendocrine tumor; small-cell carcinoma of the lung, breast cancer[8]
placental alkaline phosphatase (PLAP) | seminoma, dysgerminoma, embryonal carcinoma[8]
prostate-specific antigen (PSA) | prostate[8]
S100 protein | melanoma, sarcoma (neurosarcoma, lipoma, chondrosarcoma), astrocytoma, gastrointestinal stromal tumor, salivary gland cancer, some types of adenocarcinoma, histiocytic tumor (dendritic cell, macrophage)[8]
smooth muscle actin (SMA) | gastrointestinal stromal tumor, leiomyosarcoma, PEComa[8]
synaptophysin | neuroendocrine tumor[8]
thymidine kinase | lymphoma, leukemia, lung cancer, prostate cancer[16]
thyroglobulin (Tg) | post-operative marker of thyroid cancer (but not in medullary thyroid cancer)[8]
thyroid transcription factor-1 (TTF-1) | all types of thyroid cancer, lung cancer[8]
Tumor M2-PK | colorectal cancer,[17] Breast cancer,[18][19] renal cell carcinoma[20] lung cancer,[21][22] pancreatic cancer,[23] esophageal cancer,[24] stomach cancer,[24]cervical cancer,[25] ovarian cancer,[26]
vimentin | sarcoma, renal cell carcinoma, endometrial cancer, lung carcinoma, lymphoma, leukemia, melanoma[8]

## Accuracy and specific use

[edit]

The ideal tumor marker has the following characteristics:

* Specificity to a certain type of tumor
* Should detect the malignancy earlier than a clinical diagnosis
* Be highly sensitive to avoid false positives
* The level of tumor marker should indicate the state of the malignancy to be able to monitor treatment response.

An ideal tumor marker does not exist, and how they are clinically applied depends on the specific tumor marker. For example, tumor markers like Ki-67 can be used to choose form of treatment or in prognostics but are not useful to give a diagnosis, while other tumor markers have the opposite functionality. Therefore it's important to follow the guidelines of the specific tumor marker.

Tumor markers are mainly used in clinical medicine to support a diagnosis and monitor the state of malignancy or reocurrence of cancer.[4]

## See also

[edit]

* Tumor antigen
* List of cancer types
* Cancer biomarker

## References

[edit]

1. ^ Faria, S. C.; Sagebiel, T.; Patnana, M.; Cox, V.; Viswanathan, C.; Lall, C.; Qayyum, A.; Bhosale, P. R. (April 2019). "Tumor markers: myths and facts unfolded". Abdominal Radiology. 44 (4): 1575–1600\. doi:10.1007/s00261-018-1845-0. PMID 30498924.1575-1600&rft.date=2019-04&rft_id=info:doi/10.1007/s00261-018-1845-0&rft_id=info:pmid/30498924&rft.aulast=Faria&rft.aufirst=S.+C.&rft.au=Sagebiel,+T.&rft.au=Patnana,+M.&rft.au=Cox,+V.&rft.au=Viswanathan,+C.&rft.au=Lall,+C.&rft.au=Qayyum,+A.&rft.au=Bhosale,+P.+R.&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
2. ^ a b c Sokoll, Lori J.; Chan, Daniel W. (2020), "Tumor markers", Contemporary Practice in Clinical Chemistry, Academic Press, pp. 779–793, doi:10.1016/B978-0-12-815499-1.00044-2, ISBN 978-0-12-815499-1779-793&rft.date=2020&rft_id=info:doi/10.1016/B978-0-12-815499-1.00044-2&rft.isbn=978-0-12-815499-1&rft.aulast=Sokoll&rft.aufirst=Lori+J.&rft.au=Chan,+Daniel+W.&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
3. ^ a b Nagpal, Madhav; Singh, Shreya; Singh, Pranshu; Chauhan, Pallavi; Zaidi, Meesam Abbas (2016). "Tumor markers: A diagnostic tool". National Journal of Maxillofacial Surgery. 7 (1): 17–20\. doi:10.4103/0975-5950.196135. PMC 5242068. PMID 28163473.17-20&rft.date=2016&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5242068#id-name=PMC&rft_id=info:pmid/28163473&rft_id=info:doi/10.4103/0975-5950.196135&rft.aulast=Nagpal&rft.aufirst=Madhav&rft.au=Singh,+Shreya&rft.au=Singh,+Pranshu&rft.au=Chauhan,+Pallavi&rft.au=Zaidi,+Meesam+Abbas&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5242068&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
4. ^ a b Sharma, S. (2009). "Tumor markers in clinical practice: General principles and guidelines". Indian Journal of Medical and Paediatric Oncology. 30 (1): 1–8\. doi:10.4103/0971-5851.56328. PMC 2902207. PMID 20668599.1-8&rft.date=2009&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902207#id-name=PMC&rft_id=info:pmid/20668599&rft_id=info:doi/10.4103/0971-5851.56328&rft.aulast=Sharma&rft.aufirst=S.&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902207&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
5. ^ Hayes, D. F.; Bast, R. C.; Desch, C. E.; Fritsche, H.; Kemeny, N. E.; Jessup, J. M.; Locker, G. Y.; Macdonald, J. S.; Mennel, R. G.; Norton, L.; Ravdin, P.; Taube, S.; Winn, R. J. (16 October 1996). "Tumor Marker Utility Grading System: a Framework to Evaluate Clinical Utility of Tumor Markers". JNCI Journal of the National Cancer Institute. 88 (20): 1456–1466\. doi:10.1093/jnci/88.20.1456. PMID 8841020.1456-1466&rft.date=1996-10-16&rft_id=info:doi/10.1093/jnci/88.20.1456&rft_id=info:pmid/8841020&rft.aulast=Hayes&rft.aufirst=D.+F.&rft.au=Bast,+R.+C.&rft.au=Desch,+C.+E.&rft.au=Fritsche,+H.&rft.au=Kemeny,+N.+E.&rft.au=Jessup,+J.+M.&rft.au=Locker,+G.+Y.&rft.au=Macdonald,+J.+S.&rft.au=Mennel,+R.+G.&rft.au=Norton,+L.&rft.au=Ravdin,+P.&rft.au=Taube,+S.&rft.au=Winn,+R.+J.&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
6. ^ Koepke, John A. (15 March 1992). "Molecular marker test standardization". Cancer. 69 (S6): 1578–1581\. doi:10.1002/1097-0142(19920315)69:6+<1578::AID-CNCR2820691312>3.0.CO;2-K. PMID 1540898.1578-1581&rft.date=1992-03-15&rft_id=info:doi/10.1002/1097-0142(19920315)69:6+<1578::AID-CNCR2820691312>3.0.CO;2-K&rft_id=info:pmid/1540898&rft.aulast=Koepke&rft.aufirst=John+A.&rft_id=https://doi.org/10.1002%2F1097-0142%2819920315%2969%3A6%2B%3C1578%3A%3AAID-CNCR2820691312%3E3.0.CO%3B2-K&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
7. ^ "Ensuring the Quality of Laboratories Performing Genetic Tests". Promoting Safe and Effective Genetic Testing in the United States: Final Report of the Task Force on Genetic Testing. Johns Hopkins University Press. 1998. ISBN 978-0-8018-5952-6.
8. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af Page 746 in: Title Manual of clinical oncology Spiral manual Manual of Clinical Oncology Lippincott Manual Series Authors Dennis Albert Casciato, Mary C. Territo Editors Dennis Albert Casciato, Mary C. Territo Contributor Mary C. Territo Edition 6, illustrated Publisher Lippincott Williams & Wilkins, 2008 ISBN 0-7817-6884-5, ISBN 978-0-7817-6884-9
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10. ^ Gion, M; Mione, R; Leon, A.E; Lüftner, D; Molina, R; Possinger, K; Robertson, J.F (February 2001). "CA27.29". European Journal of Cancer. 37 (3): 355–363\. doi:10.1016/s0959-8049(00)00396-8. PMID 11239757.355-363&rft.date=2001-02&rft_id=info:doi/10.1016/s0959-8049(00)00396-8&rft_id=info:pmid/11239757&rft.aulast=Gion&rft.aufirst=M&rft.au=Mione,+R&rft.au=Leon,+A.E&rft.au=Lüftner,+D&rft.au=Molina,+R&rft.au=Possinger,+K&rft.au=Robertson,+J.F&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
11. ^ Lee, Tsinrong; Teng, Thomas Zheng Jie; Shelat, Vishal G (27 December 2020). "Carbohydrate antigen 19-9 — tumor marker: Past, present, and future". World Journal of Gastrointestinal Surgery. 12 (12): 468–490\. doi:10.4240/wjgs.v12.i12.468. PMC 7769746. PMID 33437400.468-490&rft.date=2020-12-27&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769746#id-name=PMC&rft_id=info:pmid/33437400&rft_id=info:doi/10.4240/wjgs.v12.i12.468&rft.aulast=Lee&rft.aufirst=Tsinrong&rft.au=Teng,+Thomas+Zheng+Jie&rft.au=Shelat,+Vishal+G&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769746&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
12. ^ Osman N, O'Leary N, Mulcahy E, Barrett N, Wallis F, Hickey K, Gupta R (September 2008). "Correlation of serum CA125 with stage, grade and survival of patients with epithelial ovarian cancer at a single centre". Ir Med J. 101 (8): 245–7\. PMID 18990955.245-7&rft.date=2008-09&rft_id=info:pmid/18990955&rft.aulast=Osman&rft.aufirst=N&rft.au=O'Leary,+N&rft.au=Mulcahy,+E&rft.au=Barrett,+N&rft.au=Wallis,+F&rft.au=Hickey,+K&rft.au=Gupta,+R&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
13. ^ Bast, R.C.; Xu, F.-J.; Yu, Y.-H.; Barnhill, S.; Zhang, Z.; Mills, G.B. (October 1998). "CA 125: The past and the Future". The International Journal of Biological Markers. 13 (4): 179–187\. doi:10.1177/172460089801300402. PMID 10228898.179-187&rft.date=1998-10&rft_id=info:doi/10.1177/172460089801300402&rft_id=info:pmid/10228898&rft.aulast=Bast&rft.aufirst=R.C.&rft.au=Xu,+F.-J.&rft.au=Yu,+Y.-H.&rft.au=Barnhill,+S.&rft.au=Zhang,+Z.&rft.au=Mills,+G.B.&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
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16. ^ Hallek, M.; Wanders, L.; Strohmeyer, S.; Emmerich, B. (July 1992). "Thymidine kinase: a tumor marker with prognostic value for non-Hodgkin's lymphoma and a broad range of potential clinical applications". Annals of Hematology. 65 (1): 1–5\. doi:10.1007/BF01715117. PMID 1643153.1-5&rft.date=1992-07&rft_id=info:doi/10.1007/BF01715117&rft_id=info:pmid/1643153&rft.aulast=Hallek&rft.aufirst=M.&rft.au=Wanders,+L.&rft.au=Strohmeyer,+S.&rft.au=Emmerich,+B.&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
17. ^ Haug, U; Rothenbacher, D; Wente, M N; Seiler, C M; Stegmaier, C; Brenner, H (2007). "Tumour M2-PK as a stool marker for colorectal cancer: Comparative analysis in a large sample of unselected older adults vs colorectal cancer patients". British Journal of Cancer. 96 (9): 1329–34\. doi:10.1038/sj.bjc.6603712. PMC 2360192. PMID 17406361.1329-34&rft.date=2007&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360192#id-name=PMC&rft_id=info:pmid/17406361&rft_id=info:doi/10.1038/sj.bjc.6603712&rft.aulast=Haug&rft.aufirst=U&rft.au=Rothenbacher,+D&rft.au=Wente,+M+N&rft.au=Seiler,+C+M&rft.au=Stegmaier,+C&rft.au=Brenner,+H&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360192&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
18. ^ Lüftner, D.; Mesterharm, J.; Akrivakis, C.; Geppert, R.; Petrides, P. E.; Wernecke, K. D.; Possinger, K. (2000). "Tumor type M2 pyruvate kinase expression in advanced breast cancer". Anticancer Research. 20 (6D): 5077–5082\. PMID 11326672. INIST 1059012.5077-5082&rft.date=2000&rft_id=info:pmid/11326672&rft.aulast=Lüftner&rft.aufirst=D.&rft.au=Mesterharm,+J.&rft.au=Akrivakis,+C.&rft.au=Geppert,+R.&rft.au=Petrides,+P.+E.&rft.au=Wernecke,+K.+D.&rft.au=Possinger,+K.&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
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22. ^ Oremek, G; Kukshaĭte, R; Sapoutzis, N; Ziolkovski, P (2007). "The significance of TU M2-PK tumor marker for lung cancer diagnostics". Klinicheskaia Meditsina. 85 (7): 56–8\. PMID 17882813.56-8&rft.date=2007&rft_id=info:pmid/17882813&rft.aulast=Oremek&rft.aufirst=G&rft.au=Kukshaĭte,+R&rft.au=Sapoutzis,+N&rft.au=Ziolkovski,+P&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
23. ^ Hardt, PD; Ngoumou, BK; Rupp, J; Schnell-Kretschmer, H; Kloer, HU (2000). "Tumor M2-pyruvate kinase: A promising tumor marker in the diagnosis of gastro-intestinal cancer". Anticancer Research. 20 (6D): 4965–8\. PMID 11326648.4965-8&rft.date=2000&rft_id=info:pmid/11326648&rft.aulast=Hardt&rft.aufirst=PD&rft.au=Ngoumou,+BK&rft.au=Rupp,+J&rft.au=Schnell-Kretschmer,+H&rft.au=Kloer,+HU&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
24. ^ a b Kumar, Yogesh; Tapuria, Niteen; Kirmani, Naveed; Davidson, Brian R. (2007). "Tumour M2-pyruvate kinase: A gastrointestinal cancer marker". European Journal of Gastroenterology & Hepatology. 19 (3): 265–276\. doi:10.1097/MEG.0b013e3280102f78. PMID 17301655.265-276&rft.date=2007&rft_id=info:doi/10.1097/MEG.0b013e3280102f78&rft_id=info:pmid/17301655&rft.aulast=Kumar&rft.aufirst=Yogesh&rft.au=Tapuria,+Niteen&rft.au=Kirmani,+Naveed&rft.au=Davidson,+Brian+R.&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
25. ^ Kaura, B; Bagga, R; Patel, FD (2004). "Evaluation of the Pyruvate Kinase isoenzyme tumor (Tu M2-PK) as a tumor marker for cervical carcinoma". The Journal of Obstetrics and Gynaecology Research. 30 (3): 193–6\. doi:10.1111/j.1447-0756.2004.00187.x. PMID 15210041.193-6&rft.date=2004&rft_id=info:doi/10.1111/j.1447-0756.2004.00187.x&rft_id=info:pmid/15210041&rft.aulast=Kaura&rft.aufirst=B&rft.au=Bagga,+R&rft.au=Patel,+FD&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">
26. ^ Ahmed, AS; Dew, T; Lawton, FG; Papadopoulos, AJ; Devaja, O; Raju, KS; Sherwood, RA (2007). "M2-PK as a novel marker in ovarian cancer. A prospective cohort study". European Journal of Gynaecological Oncology. 28 (2): 83–8\. PMID 17479666.83-8&rft.date=2007&rft_id=info:pmid/17479666&rft.aulast=Ahmed&rft.aufirst=AS&rft.au=Dew,+T&rft.au=Lawton,+FG&rft.au=Papadopoulos,+AJ&rft.au=Devaja,+O&rft.au=Raju,+KS&rft.au=Sherwood,+RA&rfr_id=info:sid/en.wikipedia.org:Tumor+marker" class="Z3988">

## External links

[edit]

* Media related to Biological tumor markers at Wikimedia Commons
* Tumor+Markers,+Biological at the U.S. National Library of Medicine Medical Subject Headings (MeSH)

* v
* t
* e

Tumor markers

Blood|

| Lymphoma|

* Neprilysin

|

Lymphosarcoma|

* CD3
* CD79a

Endocrine|

| Thyroid cancer|

* Thyroglobulin
* Medullary thyroid cancer (Calcitonin
* Carcinoembryonic antigen)

|

Pheochromocytoma|

* Normetanephrine
* Enolase 2

Neuroendocrine tumors|

* Synaptophysin
* Chromogranin A

Neuroblastoma|

* Homovanillic acid

Nervous system|

| Brain tumor|

* PCNA

|

Astrocytoma|

* Glial fibrillary acidic protein

NC/Melanoma|

* S100 protein
* Melanoma inhibitory activity

Cardiovascular/
respiratory|

| Lung cancer|

* Carcinoembryonic antigen
* Enolase 2
* Autocrine motility factor
* hPG80

|

Hemangiosarcoma (endothelium)|

* Factor VIII

Digestive|

| Colorectal cancer|

* CA19-9
* Carcinoembryonic antigen
* hPG80

|

Pancreatic cancer|

* CA19-9
* Carcinoembryonic antigen
* CA 242
* Tumor-associated glycoprotein 72
* hPG80

Hepatocellular carcinoma|

* Alpha-fetoprotein/AFP-L3

Reproductive/
urinary/
breast|

| Ovarian tumor|

* Surface epithelial-stromal tumor
* CA-125
* EC
* CD30
* hCG
* EST
* Alpha-fetoprotein
* Choriocarcinoma
* hCG
* Dysgerminoma
* LDH
* Sertoli–Leydig cell tumour
* Testosterone
* GCT
* Inhibin
* hPG80

|

Testicular cancer|

* βhCG
* Alpha-fetoprotein/AFP-L3
* CD30
* hPG80

Prostate cancer|

* Prostate-specific antigen
* Prostatic acid phosphatase
* Glutamate carboxypeptidase II
* erbB-3 receptor
* Early prostate cancer antigen-2
* SPINK1
* GOLM1
* PCA3
* TMPRSS2
* hPG80

Germ cell tumor|

* NANOG

Bladder cancer|

* erbB-3 receptor
* NMP22

Breast cancer|

* CA 15-3
* erbB-2 receptor
* erbB-3 receptor
* Cathepsin D
* CA 27-29
* hPG80

General histology|

| Sarcoma|

* Vimentin

|

Carcinoma (epithelium)|

* Cytokeratin

Musculoskeletal|

| Rhabdomyosarcoma|

* Desmin

|

* v
* t
* e

Clinical biochemistry blood tests

Electrolytes|

* Sodium
* Potassium
* Chloride
* Calcium
* Renal function
* Creatinine
* Urea
* BUN-to-creatinine ratio
* Plasma osmolality
* Serum osmolal gap

Acid-base|

* Anion gap
* Arterial blood gas
* Base excess
* Bicarbonate
* CO2 content
* Lactate

Iron tests|

* Ferritin
* Serum iron
* Transferrin saturation
* Total iron-binding capacity
* Transferrin
* Transferrin receptor

Hormones|

* ACTH stimulation test
* Thyroid function tests
* Thyroid-stimulating hormone

Metabolism|

* Blood glucose
* Hemoglobin A1c
* Lipid panel
* LDL
* HDL
* Triglycerides
* Total cholesterol
* Basic metabolic panel
* Comprehensive metabolic panel

Cardiovascular|

* Cardiac marker
* Troponin test
* CPK-MB test
* Lactate dehydrogenase
* Myoglobin
* Glycogen phosphorylase isoenzyme BB

Liver function tests|

* Proteins
* Human serum albumin
* Serum total protein
* ALP
* transaminases
* ALT
* AST
* AST/ALT ratio
* GGT
* Bilirubin
* Unconjugated
* Conjugated

Pancreas|

* Amylase
* Lipase
* Pancreatic lipase

Small molecules|

| Blood sugar level|

* Hypoglycemia
* Hyperglycemia

|

Nitrogenous|

* Azotemia
* Hyperuricemia
* Hypouricemia

Proteins|

| LFT|

* Elevated transaminases
* Elevated ALP
* Hypoproteinemia
* Hypoalbuminemia
* Hyperproteinemia

|

Other|

* Elevated alpha-fetoprotein

Authority control databases: National |

* Germany
* United States
* Japan
* Czech Republic
* Israel

|

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