Tumor Marker Tests

Tumor markers are substances that can be detected in higher than normal amounts in the blood, urine, or body tissues of some people with certain types of cancer. A tumor marker may be produced by the tumor itself, or by the body in response to a cancer presence. When diagnosing cancer, blood and pieces of tumor tissue are tested. These tests help to determine the characteristics of the tumor (aggressiveness, rate of growth, and degree of abnormality). Tests for tumor markers may be used with other tests or x-rays to detect and diagnose some cancers.

Tumor markers may be proteins, antigens, or hormones. Tumor marker tests are not used alone in diagnosis because most markers can be found in elevated levels in people who have benign conditions, and because no tumor marker is specific to a particular cancer. Not every tumor will cause an elevation in the tumor marker test, especially in the early stages of cancer. Physicians can use changes in tumor marker levels to follow the course of the disease, to measure the effect of treatment, and to check for recurrence.

Listed on the next page are several different tumor markers for certain types of cancer. They are listed in alphabetical order. Certain tumor markers are simply more accurate than others in their sensitivity to detection of cancer. The more sensitive they are, the earlier it is possible to diagnose. Normal levels differ between people and between laboratories. The values listed on the chart are the normals established at The University of Iowa Hospitals and Clinics. Your physician is the best person to consult if you have concerns about your specific test level.

Abbreviation Guide

ml:

milliliter

U:

International Unit

ng:

nanogram

>:

greater than

pg:

picogram

<:

less than

ug:

microgram

<:

less than or equal to

u/l:

units per liter



Tumor Marker

Primary
Cancer Site

Secondary
Cancer Site
(>50%)

False Positives

Other Benign
Diseases
Detected

Normal Values

Antidiuretic Hormone (ADH)

Small cell lung cancer, adenocarcinoma


Inappropriate secretion assoc. w/pneumonia

Porphyria-a group of disorders of porphryrin metabolism which effects blood and liver

1-5 pg/ml

Alpha-feto protein (AFP)

Liver, germ cell cancer of ovaries or testis

Stomach

Pregnancy

Cirrhosis, hepatitis, toxic liver injury, inflammatory bowel disease, ataxia telangiectasia, Wiscott-Aldrich Syndrome

0-6.4 IU/ml in men and nonpregnant women

BTA (Bladder Tumor Antigen)

Bladder


Recent invasive procedure, Infection genitourinary tract, Cancer of kidney, ureters


Not detected

CA15-3 (carbohydrate antigen 15-3)

Breast

Often not elevated in early stages of breast cancer


benign breast & liver cancer

< 31 U/ml

CA19-9

Pancreas, colorectal



pancreatitis, ulcerative colitis, inflammatory bowel disease

< 33 U/ml

CA125

Ovarian

Breast, colorectal, uterus, cervix, pancreas, liver, lung

Pregnancy, Menstration

Endometriosis, ovarian cysts, fibroids, cirrhosis, peritonitis, pancreatitis, pleural effusion, pelvic inflammatory disease

0-35 U/ml

Calcitonin

Thyroid medullary carcinoma

Ectopic calcitonin-producing tumors (rare)



Basal:
< 0.155 ng/ml for men
< 0.105 ng/ml for women

Carcinoembryonic antigen (CEA)

Colon

Kidney, thyroid, liver, lymphoma, lung, stomach, melanoma, bladder, ovary, cervix, breast, pancreas, stomach, bladder

Cigarette smoking
About 5% of the population has above normal CEA

pancreatitis, hepatitis, COPD, lung infection, inflammatory bowel disease, biliary obstruction

< 3 ng/ml in non-smokers

< 5 ng/ml in smokers

Creatin-kinase-CK

Breast, ovary, colon, prostate



renal failure, bowel infarction, stroke

40-200 u/l in men
35-150 u/l in women

hCG (human chorionic gonadotropin)

Trophoblastic disease, Choriocarcinoma

Germ cell tumors

Pregnancy, marijuana smoking, testicular failure

duodenal ulcers, cirrhosis, inflammatory bowel disease, benign breast, lung, pancreas, ovary, or GI cancer

> 31 IU/ml

Her2neu (cerbB2)

Breast




No "normal". The test is to determine if the tissue over expresses her2heu.

Lactic dehydrogenase (LDH)

Lymphoma, seminoma, acute leukemia, metastatic carcinoma



hepatitis, myocardial infarction

100-210 u/l

Neuron-specific enolase (NSE)

Neuroblastoma, small cell lung cancer




< 13 ng/ml

NMP 22

Bladder


Recent invasive procedure, Chemotherapy, Infection of genitourinary tract, Benign genitourinary disease, renal or bladder stones


< 10

Prostatic acid phosphatase (PAP)

Metastatic cancer of prostate, myeloma, lung cancer, osteo-genic sarcoma

Testicular, leukemia and non-Hodgkin's lymphoma


prostatitis, nodular prostatic hypertrophy, Gaucher's disease, osteoporosis, cirrhosis of the liver, pulmonary embolism hyperparathyroidism

0.5-1.9 u/l

Prostate specific antigen (PSA)

Prostate



benign prostatic hypertrophy, nodular prostatic hyperplasia, prostatitis

< 4 ng/ml

Source: UI Cancer Information Services
Last Reviewed: April 2011

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