CEA (carcinoembryonic antigen)
Last reviewed 10/2023
The most valuable application of tumour markers has been in the detection of recurrence of malignant disease following treatment. Examples include:
- hormones:
- calcitonin - medullary thyroid carcinoma
- ACTH, ADH - small cell bronchial carcinoma
- enzymes:
- prostatic acid phosphatase - spread of prostatic carcinoma
- bone alkaline phosphatase - primary and secondary osteoblastic tumours, for example, osteogenic sarcoma; significantly, not multiple myeloma
- liver alkaline phosphatase - primary and secondary liver tumours; associated with localised intra-hepatic biliary obstruction. Other membrane bound enzymes may also increase - such as gamma glutamyl transferase
- neurone specific enolase - small cell lung cancer; elevated in 70% of untreated patients
- tumour antigens:
- carcinoembryonic antigen - post-operative colorectal carcinoma; lacks the specifity or sensitivity to establish a diagnosis of cancer
- alpha-feto protein - hepatocellular carcinoma, teratoma
- prostate specific antigen - prostatic carcinoma
- monoclonal antibodies raised to carbohydrate or glycoprotein antigenic determinants:
- CA 125 - ovarian carcinoma
- CA 15-3 - breast carcinoma
- CA 19-9 - pancreatic, gastric, hepatobiliary carcinoma