"A Man can't make a mistake can't make anything"

Saturday, 17 May 2014


Advances in science and technology in the development of immunology, bringing a process in the early detection of cancer. As well as detection diagnosis, monitoring cancer progression, and determination of prognosis. Identification of the content of the tumor can help predict the diagnosis and cause of diseases.
With the advancement of technology development and advancement of biotechnology labratorium, now can be a marker mendeketksi kegananasan. Not only from the surrounding tissue to cancer can also detect up parts of the cell.
Because the clinical symptoms of the cancer started from uncontrolled growth sell, referred to as the disease of cancer cells or tissues with the hallmark of uncontrolled growth which can infiltrate surrounding tissues and organs, but now approved cancer is caused by the accumulation of mutations in several genes. Serological tumor markers is defined as the product of a tumor of the blood which shows the reflection of the tumor mass in the body.

In malignant transformation, each splitting cells will produce new malignant cells. In this process, malignant cells require some new elements which differentiate them with nonmalignan cells of the same origin. Elements needed to be a change in cellular morphology, physiology, or changes in cell growth. The difference between a normal cell with malignant keys can be used to detect the presence of cells malignan.Dengan this case, the term was born tumor markers . Tumor markers are substances were detected in the process.
In fact, the difference between tumor cells normally appear in different levels. The existence of this makes the variation in tumor markers diverse to describe a variety of substances and diverse cellular processes. As a result, membrane antigens, hormones, enzymes, polyamine, nucleosides, oncogene products, the products of tumor suppressor genes , or DNA ploidy and propors cells in S phase in the life cycle (proliferative activity) can be classified as a tumor marker. different fields in oncology using tumor markers of different techniques depending on the needs and follow-up . For example, tumor markers in clinical oncology different in molecular biology, different for immunohistochemistry for physiology. The use of tumor markers based on the sensitivity and specificity of the marker and the ability of other methods that can be used for the same purpose

The standard definition of tumor markers in clinical oncology refers to a substance that is produced by malignant cells or substances produced by other cells in the malignant cells and the effect can be tested in body fluids. Tumor markers can be either newly synthesized substances (which are generally not produced in normal cells healthy ) and the substance that can be found in the normal organisms in very low concentrations. Determination of tumor markers in clinical oncology is very useful in a variety of processes, for example, the process of diagnosis and prognosis, as well as early detection of recurrent or metastatic disease. However, markers in clinical oncology is currently only used as a screening method for the detection of malignant disease. Marker used different on different purposes, for example, some of which are better used for follow-up and others are used for early detection. Process follow-up of malignant disease on before, during, and after the management of, and the good of the data found will provide information about the characteristics of malignancy and prognosis of the patient. In general, a very high concentration of the tumor marker is a predictor of outcome is bad.
In body fluids, tumor markers are found in low concentrations so that the required technology is very sensitive to mendeteksinya.Teknik used is based on the detection of antigen-antibody complexes. More generally, the technique used is radioimmune assay, enzyme-immune assay, and luminometric-immune assay distinguished by components that attach to the antibodies for the detection and the method of detection of the complexes formed.

Specificity and SENSITIVITY
Tumor markers have ideal conditions:
1.       appears only in tumor cells
2.       Specific to the type of tumor and the affected organ
3.       Can be assessed in the serum of patients with the same tumor type
4.       Can be assessed in the serum of patients early in tumor development and its concentration should be correlated with the danger of such tumors.
Until now, there are no known antigenic structure only on tumor.Artinya cells, antibodies that bind to tumor markers can cross-react with a particular antigen structure lainnya.Karena it, there are no tumor markers and methods that are 100% specific. Type in assessing the results obtained, notice that the increase in tumor markers can be caused by other factors that can interfere with concentration. This bias can be caused by:
·       Specificity is inadequate for the type of malignancy
·       Production of markers in high concentrations in disease nonmalignan
·       Production of markers in different psychological conditions
·       Production of healthy tissue
The use of marker combination is now often done to increase the sensitivity, because in some cases, more than one tumor markers can meningkat.Contohnya is a combination of alpha fetoprotein on βHCG and non-germinal tumors seminoma.Masing each test had a specificity of more than 90% and sensitivity reaches 60% for the combination of type tersebut.Dengan, test sensitivity increased to 95%.
Tumor markers can be classified in different ways: based on their chemical structure, tissue of origin, type malignansinya. The most commonly used classification is to combine elements of biochemistry, home network, and functional.
Protein Onkofetal
Onkofetal protein is an antigen that is generally produced in embryonic development. In adults, the production will be limited or will disappear altogether. Increased concentration in adults is caused by reactivation of certain genes that control cellular growth and are directly linked to the process of malignancy.
Carcinoembyonic antigen (CEA) is one of contohnya.Pada embryonic development, CEA is produced in the epithelial cells of the gastrointestinal tract, liver, and pancreas. CEA is important in the process of follow-up of patients with colorectal cancer because 65% of all patients (including patients with localized disease and stage I) and 100% of patients with metastases had elevated CEA. In addition, the marker is also used for follow-up pasoen with other malignancies such as breast, ovarian, pancreatic, lung, liver, and endometrium.
Serum concentrations between 4-10 ng / ml can be found in patients with malignancies or patients with benign diseases, even in smokers berat.Sementara it, concentrations above 10 ng / ml had led to malignansi.Peningatan serum concentrations were also found in patients with bronchitis , gastrtis, duodenal ulcer, liver disease, pancreatitis, and colorectal polyposis.
Alpha-fetoprotein (AFP) is a glycoprotein produced in the yolk sac , epithelial cells of the gastrointestinal tract, and liver during development embrional.Pada pregnancy, amniotic fluid AFP enters the blood through the fetus, through the placenta, and blood maternal.Pada toward adults, AFP can found in the blood in very low concentrations. Normal serum concentration achieved at the age of 9 months after birth. Increased serum AFP levels (above 10 ng / ml) in adults can be found in patients with acute viral hepatitis, liver cirrhosis, obstructive jaundice, and the malignant disease, as well as in pancreatic cancer, lung cancer, and gastric cancer.
The main function of AFP is a follow-up of patients with hepatocellular carcinoma (95-100% sepsifisitas and sensitivity). Concentration to 1200 ng / ml confirming the diagnosis of the primary cancer and patients with non-seminoma germ tumors (specificity 60%).
1.       the HCG
HCG (human chorionic gonadotrophin) is a hormone hCG is luteotrofik in several species, including humans, mice, rabbits, pigs and so on. hCG is secreted by the placenta, hCG in women contribute to maintain the corpora lutea during the early stage of pregnancy. Immediately after ovulation, the corpus luteum will suffice got a boost from the pituitary luteotrofik factors. The drive is causing the corpus luteum remains physiologically active until hCG begin to be formed in an amount sufficient to act as luteotrofik. Measurable amount of hCG that can arise in a pregnant woman on days 5 to 16 after ovulation, but did not reach its peak titer of hCG pregnancy until the 35th to 50. Specific properties hCG isolated tend to be less uniform than the properties specific glycoprotein hormone derived from the pituitary, mainly due to the degradation of the carbohydrate side chains may occur during the formation of urine. Approximately ten days after the egg is fertilized sperm in the fallopian tubes channels, the fertilized egg moves toward the uterus and attached to the walls. Since then, the placenta begins to develop and produce hCG can be found in the blood and urine. The existence of this protein hormone can be detected in the blood since the first day of the delay period, which is roughly six days since the attachment's being of the fetus to the uterine wall.
The hormone levels continue to increase up to 14-16 weeks of pregnancy, starting from the day of the last menstrual period. Most pregnant women experience as much as the addition of hCG levels double every 3 days. Increased levels of this hormone is usually marked by nausea and dizziness are often felt by pregnant women. Once the levels are slowly declining steadily, and almost reached normal levels shortly after birth. The pregnancy hormone found only in pregnant woman's body is made by the embryo soon after conception and due to the growth of placental tissue. Pregnancy hormone produced by the villi choriales resulted in increased production of progesterone by the ovaries that suppress menstruation and maintain pregnancy. HCG production will increase to approximately 70 days and will decrease during the remainder of the pregnancy. Pregnancy hormone HCG may have additional functions, for example, estimated HCG affects the immune tolerance in pregnancy, but there are times when hormone levels are still above normal until 4 weeks after childbirth or miscarriage. High levels of HCG in the blood causes nausea-vomiting (morning sickness). Human Chorionic Gonadatrophin (hCG) is a hormone that works much like LH (luteinising hormone) which is normally produced by the pituitary gland. In boys LH and hCG also tells the testes to produce male sex hormones (testosterone).

HCG set to prevent the disintegration of the corpus luteum in the ovary and also maintain progesterone production that is critical in pregnancy in humans. HCG may have additional functions, for example HCG is estimated to affect immune tolerance in pregnancy. Estimated levels of hCG in the blood: the higher hCG levels in pregnant women commonly encountered in twin pregnancies and pregnant cases of wine (mola). While the non-pregnant women and also men, hCG levels above normal may indicate a tumor in the reproductive organs.
Not only that, hCG levels are too low to warrant concern pregnant women, because it can mean the pregnancy occurs outside the uterus (ectopic) or fetal death which is called a spontaneous abortion. hCG as an indicator of pregnancy test pregnancy test kit for use at home (home pregnancy test, HPT) commonly known as the test pack is a practical tool that is accurate enough to detect pregnancy at an early stage. inggi at that time. More accurate pregnancy test of course is a quantitative test of hCG in the blood. Usually measured is the number of the beta subunit of hCG (ß-hCG). When pregnancy occurs in a woman's self, the body reacts by forming the changes and immediately produce the hormones of pregnancy in order to support the continuation of the pregnancy. The hormones of pregnancy is intended to support the ongoing pregnancy in particular so that the fetus can grow and develop well and healthy. It's good to know about the maternal hormone produced during pregnancy following functions and effects produced by it, in order to avoid misunderstanding or even making the myth of pregnancy on the changes that occur during pregnancy.
2.       steroids
Can be secreted by the adrenal gland tumor, in certain circumstances some cases of benign stromal ovarian tumors showed an increase steroiddogenesis.
3.       Inhibitin
Hormonm glycoprotein heterodimer is produced by ovarian granulosa cells. With physiological function as inhibition of FSH by the pituitary gland spending. The increase in the hormone on granulosa cell tumor menunjkan Human placental lactogen
4.       the human placental lactogen (hPL)
also called human chorionic somatomammotropin (HCS), is a polypeptide placental hormone. The structure and function is similar to the growth hormone as a modification of metabolic state manusia.berfungsi mother during pregnancy to facilitate the energy supply of the fetus. hPL has anti-insulin. hPL is a hormone that is secreted by the syncytiotrophoblast during pregnancy. Such as human growth hormone, hPL is encoded by a gene on chromosome 17q22-24.diidentifikasi in 1963.   hPL only   during pregnancy, with increased serum levels in relation to fetal and placental growth. The maximum level is achieved, usually 5-7 mg / L. The higher levels found in patients with multiple pregnancies. Little hPL enters the fetal circulation. Biological half-life of 15 minutes.
hPL has functions such as   prolactin, but it is unclear whether hPL have a role in human lactation. hPL affect maternal organism's metabolic system. hPL lowering maternal insulin sensitivity, and, therefore, increases the mother's blood glucose levels, while decreasing maternal glucose utilization, which helps ensure adequate fetal nutrition (maternal endocrine pancreas responds by upregulation). Chronic hypoglycemia causes an increase in hPL. hPL induces lipolysis to release free fatty acids. By fasting and release of hPL, free fatty acids become available for the maternal organism as a fuel, so that relatively more glucose can be utilized by the fetus. Also, ketones are formed from free fatty acids can cross the placenta and are used by the fetus. This function helps support fetal nutrition even in the case of maternal malnutrition. hPL has been used as an indicator of tumor Placental site trofoblastic
Several specific enzymes produced more if the malignancy arises in organisms, so it can be used as a tumor marker .
1.        prostatic acid phosphatase (PAP)
is an enzyme produced by the prostate tissue olhe normal.Peningkatan konsnetrasi (more than 3 ng / ml) can be found in patients with prostate cancer and is generally associated with the late phase of the disease when the tumor mempenestasi prostate capsule. Determination of PAP can be used to distinguish benign to malignant processes.
2.       Alkaline phosphatase (AP)
appears in the form of the iso-enzymes are synthesized in the liver, bone, or plasenta.Peningkatan serum concentrations in patients with malignant disease generally indicates metastasis to the liver and / or bone, and / or the presence of a primary tumor of bone (osteosarcoma).
3.       Neuron specific enolase (NSE)
is a cytoplasmic glycolytic enzyme that was first detected in cells with neuroectodermal origin and neuronal.Seiring with the development of knowledge, NSE was found in tumor tissues with neuroectodermal and neuroendocrine differentiation.
4.       Lactic dehydrogenase (LDH)
often found to be increased in patients with malignant lymphoma and germinal tumors. gamma glutamyl transpeptidase (GGT) cholestasis due to metastasis indicates that hati.Sementara, thymidine kinase (TK) can help evaluate the spread of the disease in patients with leukemia, lymphoma, brain tumors, small cell lung cancer , and breast cancer.
5.       PSA
Prostate-specific antigen (PSA), also known as gamma-seminoprotein or kallikrein-3 (KLK3), a glycoprotein enzyme in humans is encoded by the KLK3 gene. PSA is a member of the kallikrein-related peptidase family and secreted by the epithelial cells of the prostate gland. PSA is produced for the ejaculate where it liquefy semen in the seminal coagulum and allows the sperm to swim freely, It is also believed to play a role in dissolving the cervical mucus, which allows the entry of sperm into the uterus ..
PSA is present in small quantities in the serum of men with healthy prostates, but is often elevated in prostate cancer or other prostate disorders. [4] United States Preventive Services Task Force (USPSTF, 2012) does not recommend PSA screening, noting that the test could lead to "overdiagnosis" and "overtreatment" because "mostly asymptomatic prostate cancer to live," and involves the risk of treatment complications. USPSTF concluded "the potential benefits do not outweigh the expected hazards
6.       Prostate-specific membrane antigen (PSMA)
(Also known as glutamate carboxypeptidase II) is an integral membrane glycoprotein of type 2 is found in prostate tissue and other tissues. It is possible therapeutic target for prostate cancer. Although it is a marker for prostate cancer little is known about its function in the body. expressed on tumor cells as a noncovalent homodimer
7.       Beta-2-microglobulin  (B2M)
Type of cancer: multiple myelomachronic lymphocytic leukemia , and some lymphomas, network analysis: blood, urine, or CSF fluid, to detect and determine the prognosis.
Tumor antigens
1.        CA-125
Early detection of ovarian cancer, The potential role of CA-125 for the early detection of ovarian cancer is controversial and has not been adopted for screening efforts in women without symptoms of the major problems with the use of CA-125 biomarker is a lack of sensitivity, especially for the detection of early stage ovarian cancer, and lack of specificity, especially in premenopausal women. This limitation means that the CA-125 test often gives false positive for ovarian cancer and put the patient through further testing is not needed (sometimes including surgery) and anxiety. Also, these limitations mean that many women with early stage ovarian cancer will receive a false negative of CA-125 testing and no further treatment for their condition.
Specificity and sensitivity
CA-125 has a limited specificity for ovarian cancer have elevated CA-125 levels can be found in individuals without ovarian cancer. For example, while CA-125 is known as a marker for ovarian cancer, can also be elevated in other cancers, including endometrial cancer, fallopian tube cancer, lung cancer, breast cancer and gastrointestinal cancers. CA -125 can also be elevated in some relatively benign conditions, such as endometriosis, ovarian diseases, menstruation and pregnancy. It also tends to increase with the presence of inflammatory conditions in the stomach, cancer and benign, as well as in cirrhosis and diabetes mellitus. Thus, the CA-125 test is not specific for ovarian cancer perfect and often produce false positives. Specificity of CA-125 is very low in premenopausal women because many benign conditions that cause fluctuations in CA-125 levels such as menstruation, pregnancy, and pelvic inflammatory disease, seen in this population.
CA-125 test is not perfectly sensitive for the detection of ovarian cancer because not all patients with cancer will have elevated levels of CA-125 in their blood For example, 79% of all ovarian cancers. Positive for CA-125, while the rest did not express this antigen at all.Also, only about 50% of patients with early-stage ovarian cancer have raised CA-125 levels, which means that the CA-125 has very poor sensitivity for ovarian cancer before Poor sensitivity of symptoms means that the use of CA-125 for ovarian cancer detection (especially in the early stages of disease) can often lead to false negatives .. Patients who receive false negatives are unlikely to seek further treatment for their disease.
2.        CA72-4
Among the new tumor markers that have been recently proposed, CA 72-4 is of particular interest, not only for diagnosing and monitoring capabilities in certain neoplastic diseases, but also for the excellent specificity. Several studies focused on the potential clinical utility of CA 72-4 in the gastrointestinal (GI) and gynecological cancer, showed a sensitivity of about 40% in colorectal and gastric cancers and 50% for ovarian cancer, the overall specificity of more than 95%. Longitudinal evaluation of patients with malignant disease either GI or gynecological showed that a significant increase in serum CA 72-4 levels may be predictive of recurrent disease. In addition, the combination of serum markers CA 72-4 with other well-known, such as CEA and CA 19-9 for GI cancer or CA 125 for ovarian cancer, suggesting that the increase in sensitivity can be achieved without a substantial change in the overall specificity, increasing the likelihood of patient monitoring. In conclusion, these results provide a strong argument for the use of CA 72-4 in the management of neoplastic diseases
3.        CA 19-9
CA19-9 (carbohydrate antigen 19-9, also called cancer antigen 19-9 or sialylated Lewis (a) antigen) is a tumor marker that is used primarily in the management of pancreatic cancer.
Guidelines of the American Society of Clinical Oncology recommends the use of CA19-9 as a screening test for cancer, especially cancer of the pancreas. The reason is that the test may be falsely normal (false negative) in many cases, or abnormal in people who do not have cancer at all (false positives). The main use of CA19-9 Therefore, to see whether the secreting pancreatic tumor, if it happens, then the rate should fall when the tumor is treated, and they will rise again if the disease is berulang.Pada people with pancreatic masses, CA19-9 may be useful in distinguishing between cancer and other diseases of the glands.
4.        CA 54
Studies conducted on 343 women in the clinical utility of the newly developed tumor-associated mucin-type glycoprotein, CA 54/61, as a tumor marker in serum for ovarian cancer. Overall positive rate of 60% of new markers, lower than the rate of 88% was obtained with CA 125 measured simultaneously. Regarding tumor histology, CA 54/61 had a positive rate of 78% in mucinous adenocarcinoma, compared with 44% with CA 125. There was no correlation between serum levels of CA 54/61 and CA 125 (r = 0.05). CA 54/61 indicates a low level of positive in benign disease and only exceeds the cutoff value in a patient with endometrial cysts, whereas CA 125 has a positive rate of 60%.
The level of false positive for CA 125 during the first trimester of pregnancy and during menstruation is 57 and 16%, respectively, while the rate for CA 54/61 only 11 and 5%, respectively. Testing both CA 54/61 and CA 125 increase the success rate in diagnosing ovarian cancer by 95% (38 of 40 patients).
5.        Ca 15-3
CA15-3 (cancer antigen 15-3) is a tumor marker used to monitor certain cancers, especially breast cancer. It is found on the surface of various types of cancer cells and shed into the bloodstream. It is used for advanced monitoring, ie metastasis, cancer. Increased CA15-3, in conjunction with alkaline phosphatase (ALP), has been found to be associated with an increased likelihood of breast cancer recurrence early.
CA15-3 and related CA27.29 (aka BR27.29) is different epitopes on the same antigen protein product of the breast cancer-associated MUC1 gene. CA27.29 has improved sensitivity and specificity, and because it has exceeded CA15-3 as a serum tumor marker. CA27.29 increased in 30% of patients with low-stage disease and 60 to 70% of patients with breast cancer lanjut.Kedua CA27.29 and CA15-3 can be elevated in patients with benign ovarian cysts, benign breast disease, and benign liver disease. Altitude can also be seen in cirrhosis, sarcoidosis and lupus. CA27.29 level more than 100 U / mL or CA15-3 levels more than 25 U / mL is rare in benign conditions. CA27.29 possible increase in non-breast malignancies including colon, stomach, pancreas, prostate and lung.
6.        CA 242
CA 242 is a tumor marker for sialylated carbohydrate Lewis and risks associated with metastatic adenocarcinoma of E-selectin-mediated
7.        Trypsin inhibitors of tumor
ovarian cancer patients 6 kDa polypeptide, tumor-associated trypsin inhibitor (Tati), can occur in high concentrations in urine and serum well. In this study, pretreatment serum levels Tati (cut-off point of 21 ng ml-1) and CA 125 (cut-off points 35 U ml-1 and 65 U ml-1) were determined in 152 patients with epithelial ovarian cancer (115 primary and 37 recurrent) and in 267 women with benign pelvic disease. The data obtained were correlated with tumor stage, histologic type and grade of tumor. Overall, Tati showed 64% sensitivity and 75% specificity. The sensitivity and specificity of CA 125> 35 U ml-1 are both 80%. The corresponding values ​​for CA 125> 65 U ml-1 was 70% and 87%. The combination of the two markers increased sensitivity to 91% (CA 125> 35 U ml-1) and 86% (CA 125> 65 U ml-1), while the specificity decreased to respectively 61% and 68%.  clearly superior in carcinoma mucinous ovarian, level of true-positive findings in this neoplasm was 67% vs. 42% for CA 125> 35 U ml-1 and 33% for CA 125> 65 U ml-1.
Unlike CA 125, Tati correlates well with tumor grade. The combination of the two markers had a negative predictive value is higher, at 93% (CA 125> 35 U ml-1) and 90% (CA 125> 65 U ml-1), respectively. It can be concluded that, while Tati can not replace CA 125 in the diagnosis of malignant ovarian epithelial carcinoma, it is a valuable additional marker in the case of mucinous carcinoma and in combination with CA 125.
8.        follicle regulatory proteins (FRP)
secreted by ovarian granulosa cells and plays a role in modulating follicle development. A dual epitope immunoassay using two murine monoclonal antibody, IgG1 isotype (raised against pig FRP), jointly developed to measure serum FRP. FRP levels in the serum of women with granulosa cell tumors, normal, menstruating women, and postmenopausal women determined. FRP increases in serum levels 79% of women with granulosa cell tumors compared to normal controls. FRP levels in serial samples from women with granulosa cell tumors are usually correlated with the clinical course of disease. Thus, FRP may provide a useful marker for granulosa cell tumors.

9.        M-CSF
It has been demonstrated that in patients with epithelial ovarian cancer and malignant ovarian germ cell tumors, macrophage colony-stimulating factor (M-CSF) was significantly elevated in the serum compared with healthy people. Therefore, M-CSF has been proposed as a tumor marker in these cancers. In this study, the potential tumor markers of serum M-CSF concentrations in patients with squamous cell carcinoma of the head and neck (SCCHN) investigated. The concentration of serum M-CSF determined by quantitative sandwich enzyme immunoassay in 59 patients suffering from SCCHN and 59 healthy controls.
A significant difference in mean serum concentrations of M-CSF between patients with SCCHN and control groups was found (p = 0.002). M-CSF serum concentration correlates well with the stage of disease or with histopathological grading, and no correlation with serum C-reactive protein was found. The concentration of serum M-CSF could be interesting as a tumor marker in SCCHN.
10.    OVX1
The only cause of the most common causes of endometrial cancer diagnosis is postmenopausal bleeding. Although most patients with early-stage disease (FIGO stage I and II) can be cured, the prognosis worsens with increasing stage far. While serum CA 125 levels were elevated only in a significant proportion of patients with advanced disease, recent new serum markers (OVX1) to detect early-stage endometrial cancer were reported. OVX1 serum levels were measured using OVX1 radioimmunoassay (RIA) or enzyme immunoassay (EIA) in 192 patients with endometrial cancer. CA 125 levels were measured in 112 patients using the CIS ELSA CA 125 kit. Apparently healthy women OVX1 mean serum levels were measured by EIA OVX1-1.34 + / - 0.74 U / ml, whereas patients with endometriosis OVX1 mean serum level of 3.15 + / - 2.45 U / ml.  Mean OVX1 serum levels for endometrial cancer patients was 2.00 + / - 1.32 U / ml. These values ​​were 2.76 + / - 1.62, 6.10 + / - 4.66 and 5.37 + / - 3.49, respectively, using OVX1-RIA test. Applying a cutoff value of 2.8 U / ml, serum levels OVX1-EIA in endometrial cancer patients increased in 25 of 127 patients (19.7%) with stage I disease, 5 of 17 patients with stage II (29.4%) , 5 of 22 patients (22.7%) with stage III, and 4 of 11 patients (36.4%) with stage IV disease.
Using OVX1-RIA and cutoff of 7.2 U / ml, serum levels increased in 22 of 127 (17.3%) stage I, 6 of 17 (35.3%) Stage II, 5 of 22 (22.7% ) stage III, and 6 of 11 (54.5%) patients were stage IV. Serum CA 125 levels, determined in a total of 112 patients, which is elevated above 35 U / ml in 12 of 79 patients (15.2%) with stage I, 4 of 12 patients (33.3%) with stage II, 8 of 13 patients (61.5%) with stage III, and all 8 patients (100%) with stage IV disease. While a good correlation between serum CA 125 levels and clinical stage of the disease was found, no correlation could be detected for OVX1 and stage.

11.    NB70k
Circulating tumor antigen of human ovarian NB/70K assessed with four monoclonal antibody radioimmunoassays. A total of 844 blood samples from patients with ovarian cancer and gynecological control subjects were evaluated to determine the specificity of each of the four tests for ovarian cancer. It was determined that the average percentage of positive and for patients with ovarian cancer were significantly higher than the values ​​for all of the control group. When the clinical parameters of patients with ovarian cancer examined, it was found that NB/70K appear elevated in patients with all types of pathological early stage, low-grade epithelial ovarian cancer were studied.
One of the four radioimmunoassays (which NB12123 assay) capable of detecting blood NB/70K level in more than 50% of patients with early-stage ovarian malignancies. The test is also able to detect NB12123 NB/70K in the blood of 45% (9 of 20) of patients with stage I, well-differentiated ovarian cancer. These results indicate that NB/70K may be a useful marker for early detection of localized tumors and for monitoring patients with ovarian cancer, as has been demonstrated previously. In addition, NB/70K seems to be a marker for all stages, grades, and types of pathological human ovarian epithelial tumors
12.    TA 4
Serum levels of tumor antigen-4 (TA-4) were measured in 401 patients with squamous cell carcinoma (SCC) of various organs (76 lung, esophagus 82, and 234 head and neck). The average level of serum TA-4 in patients with lung SCC was 3.6 times higher than in healthy controls and even higher in advanced stage disease (III, IV). In patients with benign disease or other types of lung cancer, however, TA-4 serum levels did not differ from controls regardless of clinical stage.
During radiation therapy, TA-4 levels in patients with lung SCC decreased with a reduction in tumor size. It increased again evident during relapse. Similarly, patients with SCC of the esophagus and head and neck also showed an increase in TA-4 levels but only at an advanced stage and recurrence. It was concluded that TA-4 is associated with SCC of the uterine cervix is ​​not only but also other organs and that the determination of serum levels is useful for monitoring the effects of therapy and recurrence of the disease, although some limitations
13.    IL 2 tumor markers
Various studies have shown that soluble interleukin-2 receptor (SIL-2R) is rated as a marker of chronic and malignant disorders. No data are available on the level of SIL-2R in head and neck cancer. Serum 86 patients with squamous cell carcinoma of the head and neck (SCCHN) before any treatment and from 25 healthy controls were taken. Six months later the serum 49 patients were taken again. SIL-2R levels were determined by ELISA.
SCCHN patients with prior therapy had higher levels of serum SIL-2R significantly elevated (895 U / ml) compared with controls (437 U / ml). After eight months of follow-up 78.4% of the patients with SCCHN tumor recurrence increased and 80% of patients without recurrence carcinoma decreased levels of SIL-2R compared with before treatment. SIL-2R does not seem to be a specific marker for SCCHN and possible prognostic value.
14.    Vimentin
Vimentin is a type III intermediate filaments (IF) protein that is expressed in mesenchymal cells. IF proteins found in all metazoan cells [1] and bakteriIF, along with tubulin and microtubule-based actin-based microfilaments, composed of the cytoskeleton. All JI proteins presented in a fashion that is highly-regulated development; vimentin is the major cytoskeletal component of mesenchymal cells.
Therefore, it is often used as a marker vimentin mesenchymally-derived cells or epithelial cells undergo transition-to-m, esenchymal (EMT) during both normal development and the development of metastases, Vimentin plays an important role in supporting and retaining the position of organelles in the cytosol. Vimentin attached to the nucleus, endoplasmic reticulum, and mitochondria, both laterally and terminally.
15.    Sinaptosin
Synaptophysin, also known as a major synaptic vesicle protein p38, a protein that in humans is encoded by the SYP gene, this gene has been implicated in X-linked mental retardation.   Using immunohistochemistry, synaptophysin can be demonstrated in a variety of neural and neuroendocrine tissues, including cells of the medulla adrenal and pancreatic islets. As a specific marker for these networks, can be used to identify tumors that arise from them, such as neuroblastoma, retinoblastoma, pheochromocytoma, carcinoid, and medullary thyroid carcinoma, among others. Diagnosis, often used in combination with chromogranin A.
16.    NMP 22
NMP22 is a tumor marker for bladder cancer. NMP22 is the abbreviated form of the Nuclear Matrix Protein 22
17.    Neprilysin
Neprilysin, also known as membrane metallo-endopeptidase, neutral endopeptidase (NEP), CD10, and common acute lymphoblastic leukemia antigen (calla), is a zinc-dependent metalloprotease enzyme that degrades a number of small secreted peptides, especially beta-amyloid peptide misfolding and aggregation of abnormal the neural network has been implicated as a cause of Alzheimer's disease. Synthesized as membrane-bound proteins, neprilysin ectodomain is released into the extracellular domain after it has been transported from the Golgi apparatus to the cell surface. In neurons, neprilysin regulated by proteins nicastrin, a component of the gamma secretase complex that performs the necessary steps in the processing of amyloid precursor protein beta amyloid.
CD10 expressing hematopoietic progenitor considered "common lymphoid progenitor," meaning they can differentiate into T, B or cell Killer.CD10 Natural is the use in the diagnosis of hematological as stated at the beginning of B, pro-B and pre-B lymphocytes, and the germinal centers of lymph nodes. hematologic disease in which the positive, including ALL, angioimmunoblastic T-cell lymphoma, Burkitt's lymphoma, CML in blast crisis (90%), diffuse large B cell lymphoma (variable), follicular center cell (70%), hairy cell leukemia (10%) , and myeloma (multiple). It tends to be negative in AML, CLL, mantle cell lymphoma, and marginal zone lymphoma. CD10 is found on non-T ALL cells derived from pre-B lymphocytes, and germinal center-related non-Hodgkin lymphoma such as Burkitt's lymphoma and follicular lymphoma, but not in the cells of leukemia or lymphoma derived from more mature B cells.


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Detection / tumormarkers

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