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    Tumor Marker/Penanda Tumor: Dr. Andriani Tri Susilowati, M.SC, SPPK

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    Fahrum Burhan
    Tumor markers are biochemical substances that can be quantitatively measured in tissue or bodily fluids through biochemical or immunochemical methods. They include hormones, enzymes, cancer antigen proteins, metabolites, normal proteins, oncofetal antigens, receptors, and genetic changes. An ideal tumor marker is specific to a single cancer type, highly sensitive and specific for cancerous growth, correlates with tumor size, is homogeneous, has a short circulation half-life, is present in or produced by the tumor itself, and is not present in healthy tissue. Tumor markers can be used for screening, diagnosis, prognosis and staging, predicting treatment response, and detecting recurrence or remission. They are measured before and after treatment, and periodically during follow-

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    Tumor Marker/Penanda Tumor: Dr. Andriani Tri Susilowati, M.SC, SPPK

    Uploaded by

    Fahrum Burhan
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    Tumor markers are biochemical substances that can be quantitatively measured in tissue or bodily fluids through biochemical or immunochemical methods. They include hormones, enzymes, cancer antigen proteins, metabolites, normal proteins, oncofetal antigens, receptors, and genetic changes. An ideal tumor marker is specific to a single cancer type, highly sensitive and specific for cancerous growth, correlates with tumor size, is homogeneous, has a short circulation half-life, is present in or produced by the tumor itself, and is not present in healthy tissue. Tumor markers can be used for screening, diagnosis, prognosis and staging, predicting treatment response, and detecting recurrence or remission. They are measured before and after treatment, and periodically during follow-

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    Tumor markers are biochemical substances that can be quantitatively measured in tissue or bodily fluids through biochemical or immunochemical methods. They include hormones, enzymes, cancer antigen proteins, metabolites, normal proteins, oncofetal antigens, receptors, and genetic changes. An ideal tumor marker is specific to a single cancer type, highly sensitive and specific for cancerous growth, correlates with tumor size, is homogeneous, has a short circulation half-life, is present in or produced by the tumor itself, and is not present in healthy tissue. Tumor markers can be used for screening, diagnosis, prognosis and staging, predicting treatment response, and detecting recurrence or remission. They are measured before and after treatment, and periodically during follow-

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    Download as pptx, pdf, or txt
    20 views19 pages

    Tumor Marker/Penanda Tumor: Dr. Andriani Tri Susilowati, M.SC, SPPK

    Uploaded by

    Fahrum Burhan
    Tumor markers are biochemical substances that can be quantitatively measured in tissue or bodily fluids through biochemical or immunochemical methods. They include hormones, enzymes, cancer antigen proteins, metabolites, normal proteins, oncofetal antigens, receptors, and genetic changes. An ideal tumor marker is specific to a single cancer type, highly sensitive and specific for cancerous growth, correlates with tumor size, is homogeneous, has a short circulation half-life, is present in or produced by the tumor itself, and is not present in healthy tissue. Tumor markers can be used for screening, diagnosis, prognosis and staging, predicting treatment response, and detecting recurrence or remission. They are measured before and after treatment, and periodically during follow-

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    of 19

    TUMOR MARKER/PENANDA

    TUMOR
    Dr. Andriani Tri Susilowati, M.Sc, SpPK
    DEFINISI PENANDA TUMOR

     SUATU SENYAWA BIOKIMIA YANG DAPAT DIPERIKSA SECARA KUANTITATIF,


    BAIK SECARA BIOKIMIA MAUPUN IMUNOKIMIA DARI JARINGAN ATAU CAIRAN
    TUBUH
    TIPE PENANDA TUMOR

    • Hormones (hCG; calcitonin; gastrin; prolactin;)


    • Enzymes (acid phosphatase; alkaline phosphatase; PSA)
    • Cancer antigen proteins & glycoproteins (CA125; CA 15.3; CA19.9)
    • Metabolites (norepinephrine, epinephrine)
    • Normal proteins (thyroglobulin)
    • Oncofetal antigens (CEA, AFP)
    • Receptors (ER, PR, EGFR)
    • Genetic changes (mutations/translocations, etc.)
    KARAKTERISTIK PENANDA TUMOR YANG
    IDEAL
    • Specificity for a single type of cancer
    • High sensitivity and specificity for cancerous growth
    • Correlation of marker level with tumor size
    • Homogeneous (i.e., minimal post-translational modifications)
    • Short half-life in circulation
     tumor marker should be present in or produced by tumor itself.
     A tumor marker should not be present in healthy tissues.
     Plasma level of a tumor marker should be at a minimum level in healthy subjects and in
    benign conditions
     Simply and cheap test
    PENGGUNAAN PENANDA TUMOR

     SKRINING
     DIAGNOSTIK
     PROGNOSIS DAN STAGING
     MEMPERKIRAKAN RESPON TERAPI
     DETEKSI KEKAMBUHAN ATAU REMISI (MASIH KONTROVERSI)
     PEMANTAUAN EFEKTIFITAS TERAPI
    PENGGUNAAN PENANDA TUMOR

     SEBELUM DILAKUKAN TINDAKAN


     SETELAH TINDAKAN OPERASI ATAU PENGOBATAN
     ANTARA 2-10 HARI TINDAKAN
     SETIAP 3 BULAN SELAMA 1-2 TAHUN PERTAMA
     SETIAP 6 BULAN PADA TAHUN 3-5
     BILA DIDUGA RELAPS
    TUMOR MARKERS: PSA

    Useful for:
     Diagnosis of prostate cancer
     Prognostic factor
     Monitor recurrence & response to treatment
     ?Screening of prostate cancer (+rectal examination)
    HORMONES CALCITONIN

     Calcitonin
     Calcitonin is a hormone which decreases blood calcium concentration.
     Its elevated level is usually associated with thyroid cancer.
     Calcitonin levels appear to correlate with tumor volume and metastasis.
     Calcitonin is also useful for monitoring treatment and detecting the recurrence of
    cancer.
     calcitonin levels are also at a high levels in some patients with cancer of lung,
    breast, kidney, liver and in nonmalignant conditions such as pulmonary diseases,
    hyperparathyroidism, myeloproliferative disordes and pregnancy.
    HUMAN CHORIONIC GONADOTROPIN (HCG)

     It is a glycoprotein appears in pregnancy. Its high levels is a useful marker for


    tumors of placenta and some tumors of testes.
     hCG is also at a high level in patients with primary testes insufficiency.
     hCG does not cross the blood-brain barier. Higher levels may indicate metastase.
     Normal: less than 5 IU/L
    ONCOFETAL ANTIGENS

     α-fetoprotein
     carcinoembryonic antigen (CEA)
    Α-FETOPROTEIN (AFP)

     α-fetoprotein is a marker for liver/ testicular cancer.


     It is also increased in pregnancy and chronic liver diseases.
     AFP is useful for screening (AFP levels greater than 1000 µg/L are indicative for cancer
    except pregnancy), determining prognosis and monitoring therapy of liver cancers.
     AFP is also a prognostic indicator of survival.
     Serum AFP levels is less than 10 µg/L in healthy adults. Elevated AFP levels are
    associated with shorter survival time.
     AFP and hCG combined are useful in classifying and staging germ cell tumors.One or
    both markers are increased in those tumors.
     Normal: less than 7 ng/ml
    CARCINOEMBRYONIC ANTIGEN (CEA)

     It is a cell-surface protein and a well defined tumor marker.


     CEA is a marker for colorectal, gastrointestinal, lung and breast carcinoma.
     CEA levels are also elevated in smokers and some patients having benign
    conditions such as cirrhosis, rectal polips, ulcerative colitis and benign breast
    disease.
     CEA testing should not be used for screening. Some tumors don’t produce CEA. It
    is useful for staging and monitoring therapy (recurrence).
     Normal: 0-2.5 ng/ml
     Smokers: 0-0.5 ng/ml
    CA 19-9

     CA 19-9 is a marker for both colorectal and pancreatic carcinoma.


     However elevated levels were seen in patients with hepatobiliary, gastric, hepatocellular and breast
    cancer and in benign conditions such as pancreatitis and benign gastrointestinal diseases.
     CA 19-9 levels correlate with pancreatic cancer staging.
     It is useful in monitoring pancreatic and colorectal cancer.
     Elevated levels of CA 19-9 can indicate recurrence before detected by radiography or clinical findings
    in pancreatic and colorectal cancer.
     21-42% elevated in gastric ca
     20-40% elevated in colonic ca
     71-93% elevated in pancreatic
     Useful for differentiated benign from malignant disease
     Normal: less than 37 U/ml
    TERIMA KASIH
    TERIMA KASIH

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