Page 134 - Clinical Biochemistry

Diagnosis:
Carcinoembryonic antigen (CEA), an oncofetal antigen remains the most relevant serum
tumor marker for colorectal cancer.
Screening:
With fecal immunochemical tests (FIT), follow-up colonoscopy is required for positive tests.
Prognosis and Monitoring:
Increased preoperative CEA concentrations in patients with colorectal cancer are associated
with adverse outcome. CEA testing should be performed every 3 to 6 months for 5 years
following curative surgery for colorectal cancer.
3- Hepatocellular Carcinoma (HCC)
Diagnosis for HCC:
α-fetoprotein (AFP); oncofetal antigen increased in pregnant women and most frequently
inappropriately increased in patients HCC.
AFP measurement in conjunction with ultrasound may aid in early detection of HCC.
Screening for HCC in High-Risk Groups Using AFP
Early detection of HCC through screening of high-risk populations can improve clinical
outcome. High-risk patients include established cirrhosis due to HBV or HCV infection,
alcohol-related cirrhosis.
AFP in Prognosis
In combination with other factors, AFP concentrations may provide prognostic information in
untreated HCC patients and in those being considered for liver transplantation. Patients with
serum AFP greater than 1200 μg/L are unsuitable for transplant.
4- Prostate Cancer
Diagnosis:
Prostate-Specific Antigen (PSA) the most important serum tumor marker for this disease.
Unlike many other tumor markers, PSA is essentially organ specific. However, PSA is not
cancer-specific; Its concentrations increased in men with benign prostatic disease and/or
urinary tract infections and following intervention involving the prostate. Prostatic biopsy is
therefore required for definitive diagnosis of malignancy.
Prognosis:
The pretreatment serum PSA value correlates with the risk of extra-prostatic extension, seminal
vesicle invasion, and lymph node involvement and is a predictor of response to all forms of
treatment.