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OF COLOREATAL CANCER USING SEROLOGIC TUMOR MARKERS DIAGNOSIS & MANAGEMENT. BODY FLUID TUMOR MARKERS: 1- TUMOR-ASSOCIATED PROTEINS (ONCOFETAL ANTIGENS) 2-ONCOPROTEINS 3-PROTEOMICS. IDEALLY , A TUMOR MARKER WOULD BE: 1-TUMOR SPECIFIC
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OF COLOREATAL CANCER USING SEROLOGIC TUMOR MARKERS DIAGNOSIS & MANAGEMENT
BODY FLUID TUMOR MARKERS: • 1- TUMOR-ASSOCIATED PROTEINS (ONCOFETAL ANTIGENS) • 2-ONCOPROTEINS • 3-PROTEOMICS
IDEALLY , A TUMOR MARKER WOULD BE: • 1-TUMOR SPECIFIC • 2-ABSENT IN HEALTHY INDIVIDUALS • 3-READILY DETECTABLE IN BODY FLUIDS • 4-ELEVATE AT AN EARLY CANCER STAGE
A HOST OF T.M. HAVE A HIGH ENOUGH SPECIFICITY & SENSITIVITY TO BE USED IN: • 1-SCREENING POPULATION AT RISK & • DIAGNOSIS • 2-PROGNOSIS • OF RECURRENCE & MONITORING • 3-DETECTION RESPONSE TO TREATMENT (CEA)
OF SERUM TESTING OVER TISSUE ADVENTAGES BASED METHODS 1-IMPROVED SENCITIVITIES OF THE ASSAYS 2-IMPROVEMENT OF INSTRUMENTATION 3-NONINVASIVE NATURE 4-MORE ACCURATE QUANTIFICATION 5-LAKE OF INTER-OBSERVER DIFFERENCE
CEA THE SRUM CONCENTERATION CORRELATES WELL WITH TUMOR ACTIVITY & CAN BE USED TO PREDICT PROGNOSIS NOT SUITABLE FOR SCREENIG DON’T APPER SUFFICIENTLY EARLY LOW POSITIVE PREDICTIVE VALUE ADJUNCT TEST EXTREMELY & USEFUL FOR MONITORING THE SUCCESS OF TREATMENT & FOR DETECTING RECURRENCE ASSOCIATION BETWEEN HIGHLY ELEVATED CEA & METASTASIS & POOR PROGNOSIS
RECOMMENDATION FOR ORDERING TUMOR MARKER TESTS • NEVER RELY ON THE RESULT OF A SINGLE TEST • WHEN ORDERING SERIAL TESTING , BE CERTAIN TO ORDER EVERY TEST FROM THE SAME LAB USSING THE SAME ASSAY KIT
BE CERTAIN THAT THE T.M. SELECTED FOR MONITORING RECURRENCE WAS ELEVATED IN PATIENT PRIOR TO SURGERY • CONSIDER THE HALF-TIME OF THE T.M. & HOW IT IS REMOVED OR METABOLIZED WHEN • INTERPRETING THE TEST RESULT
CONSIDER ORDERING MULTIPLE MARKERS TO IMPROVE BOTH THE SENSITIVITY & SPECIFICITY FOR DIAGNOSIS • MAB-DEFINED T.M. ( CEA,CA19-9 , CA15-3 , CA125) • CA15-3 , CA72-4 ,CA125 • CEA , CA19-9 ,CA 72-4 (CA19-5 ,NSE, CHROMOGRANIN A ,CA50 • BE AWARE OF THE PRESENCE OF ECTOPIC T.M. • HETEROPHILIC Abs
ELEVATED SERUM VEGF • 1-BREAST , OVARIAN , HEPATOCELLULAR , COLORECTAL & RENAL CELL CARCINOMAS & SOFT TISSUE SARCOMA • 2-SHORTER SURVIVAL IN COLON CARCINOMA , RCC , OVARIAN CARCINOMA
ONCOPROTEINS&EARLY DETECTION OF COLORECTAL CANCER • TGF-A(AT AN EARLY STAGE) • RAS ONCOPROTEIN P21(75% OF COLON CANCER) • P185 ERB 2 ECD(NEU) PROTEIN,COLORECTAL TUMOR SIZE PROGRESSION • MUTANT P53 PROTEIN(1/5 CARCINOMA,1/10 ADENOMA,ELIZA) • CIRCULATING ANTI-P53 Abs(15%) • C-MYC-RELATED P40 PROTEIN • ANTI-MYC Ab • NUCLEAR MATRIX PROTEIN
DIRECTION FOR THE FUTURE • SERUM GENOMICS&PROTEOMICS ASPOTENTIAL BIOMARKERS FOR CANCER • NEW MOLECULAR TECHNIQUES IN DETECTING • CIRCULATING DNA&RNA • CIRCULATING TUMOR CELLS IN PERIPHERAL BLOOD • (RECURRENCE,METASTASIS,SENSITIVITY TO CHEMOTHERAPY)