Tumor Marker - What Is It

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Tumor Marker - What Is It
Tumor Marker - What Is It

Video: Tumor Marker - What Is It

Video: Tumor Marker - What Is It
Video: Tumor Markers in Cancer diagnosis and Monitoring 2023, March
Anonim

Laboratory findings: what are “tumor markers”?

The term “tumor markers” encompasses macromolecules circulating in the blood and in other body fluids (humoral tumor markers) or localized on cell surfaces (cellular tumor markers such as hormone receptors in breast cancer) that can be diagnostically related to malignant tumor diseases. In addition, genetic changes in certain cells or tissues are also regarded as “tumor markers”, provided that they are of diagnostic relevance.

As a rule, however, “tumor markers” should not be used as screening tests for a malignant disease in healthy people (exception: PSA screening as part of a prostate preventive examination). Rather, "tumor markers" are used to assess the course and prognosis of an already proven malignancy or for further diagnostic specification.

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“Tumor marker” - the term is misleading

In laboratory medicine, the term “tumor marker” is a misleading and problematic term both for patients and for many specialists (read: doctors).

The reason for the misunderstanding of the term is the fact that practically all tumor markers can also be elevated in some benign diseases:

  • in case of inflammation (e.g. pneumonia),
  • with infections (e.g. urinary tract infection),
  • after injuries, operations, examinations etc. (e.g. after a prostate examination).

Step-by-step diagnosis in tumor clarification

A precise step-by-step plan must always be followed in cancer screening or cancer diagnostics.

Stage 1: indication for cancer diagnostics

  • Preventive medical check-up: e.g. PAP test for cervical cancer or colonoscopy for colon cancer.
  • Further clarification of a conspicuous previous finding: e.g. shadowing in the lung x-ray or suspicious lymph node swelling, etc.

Stage 2: Morphological tumor diagnosis

  • Microscopic detection of cancer cells (cytology),
  • microscopic evidence of cancerous tissue (histology).

Stage 3: Determination of tumor markers (cell tumor markers, tissue tumor markers, blood tumor markers)

  • Detection of tumor markers on cells and tissue using special staining techniques:

    • Immunocytochemistry: With individual tumor cells (in smears, punctures, etc.), tumor markers can be detected on the cell surface or in the cell nucleus by staining.
    • Immunohistochemistry: Detection of tumor markers on or within tumor cells in the tissue structure.
  • Detection of tumor markers in the blood ("blood tumor markers") only makes sense after level two has been completed. These "laboratory tumor markers" help with:

    • Confirmation of diagnosis (confirmation of the tumor type),
    • Follow-up (does the disease progress, does it stay the same or does it improve?),
    • Detection of a relapse (eg recurrence of the tumor after primarily successful treatment).

In this step-by-step plan for the prevention or clarification of a suspected cancer, the individual steps one to three are always to be taken exactly as with stairs - namely one after the other.

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