TUMOR IMMUNOLOGY

 Tumors – are composed of cells that possess many of the attributes of the normal cells from which they arose but have
accelerated or dysregulated growth
 Can be benign or malignant
o Benign - If a tumor does not invade surrounding tissue and normal body function is largely preserved
o Malignant - can invade surrounding tissues and greatly disrupt normal body function
 Process of Conversion from Normal Cell to Malignant Cell
o Induction Phase - cells are exposed to a variety of environmental insults,
including chemical carcinogens, oncogenic viruses, and radiation (ionizing and ultraviolet) .Cells exhibit dysplasia or
abnormal growth that is not yet considered neoplasia, or consistent with a tumor.
o In Situ Phase - when neoplastic cells have formed but are confined to the tissue of origin.
o Invasion and Dissemination – phase of metastatis, wherein the malignant cells travel through the body, causing new
foci of malignancy until body function is so disrupted that death occurs
 Tumor antigens or markers
o Used for tumor screening and diagnosis, histopathologic evaluation and staging, disease monitoring and therapy
selection and localization of metastasis
MARKER CANCER USES
AFP Nonseminomatous testicular cancer, hepatoma, germ cell tumors 1,2,3,4
B-2 microglobulin Lymphocyte malignancies 2
Calcitonin and Ca 2+ Familial medullary thyroid carcinoma 1,2,3
CEA Colorectal and breast cancer 2,3,4
CA 125 Ovarian adenocarcinoma 1,2,3,4
CA 15-3 Breast adenocarcinoma, can be increased in pancreatic, lung, colorectal, ovarian 4
and liver cancers.
CA 19-9 Colonic and pancreatic adenocarcinoma 4
ER/PR Breast adenocarcinoma 2
Fecal occult blood Colorectal cancer N/A
hCG Nonseminomatous testicular cancer, choriocarcinoma 1,2,3,4
Her2/neu Breast adenocarcinoma 2
Monoclonal Ig Clonality indicates B cell malignancy 1,2,3,4
PSA Prostate cancer 1,2,3,4
PTH and Ca++ Parathyroid carcinoma 1,2,3,4
Thyroglobulin Thyroid carcinoma 3,4
1=Diagnosis/Case Finding 2=Staging/Prognosis 3=Detecting Recurrence 4=Monitoring therapy