Tumor Marker

Cancers Associated With Elevated Results (** indicates the most common association, if one exists)

Non-Cancerous Elevations

"Normal" Results

Alpha-fetoprotein (AFP) (blood serum marker)

Germ cell cancers of ovaries & Pregnancy (clears after birth), particularly embryonal and yolk sac, testicular cancers) Some primary liver cancers (hepatocellular) toxic liver injury), inflammatory bowel disease

Low levels present in pregnant women (0-15 IU/ml); generally results >400 are caused by cancer (Half-life 4-6 days) In men: < 2.5 U/ml In non-pregnant women: < 5.0 U/ml Generally, a value of 0.03-0.05 mg/ml is significant for early disease

testes** (Non-seminomatous, liver disease (hepatitis, cirrhosis, both men & non-

Beta-Human Chorionic Gonadotropin (B-HCG) (blood serum marker)

Germ cell tumors Gestational Pregnancy, marijuana use, trophoblastic disease hypogonadism (testicular failure), cirrhosis, inflammatory bowel disease, duodenal ulcers Amyloidosis

Bence-Jones Proteins (urine) Multiple Myeloma** or Monoclonal Immunoglobulins (blood) Bladder Tumor Antigen (BTA) (urine marker) CA 15-3 (Carbohydrate antigen 15-3) (blood serum marker) Waldenstrom's Macroglobulinemia Chronic Lymphocytic Leukemia Bladder cancer** Cancer of kidney or ureters

Invasive procedure or infection of bladder or urinary tract

None normally detected < 31 U/ml (30% of patients have an elevated CA 15-3 for 30-90 days after treatment, so wait 2-3 months after starting new treatment to check)

Breast** (often not elevated in Liver disease (cirrhosis, early stages of breast cancer) hepatitis), lupus, sarcoid, Lung, ovarian, endometrial, bladder, gastrointestinal tuberculosis, non-cancerous breast lesions

CA 19-9 (Carbohydrate antigen 19-9) (blood serum marker) CA 125 (Carbohydrate antigen 125) (blood serum marker)

Pancreas** and colorectal** cancers Ovarian cancer** Breast, colorectal, uterine, cervical, pancreas, liver, lung

Pancreatitis, ulcerative colitis,

< 37 U/ml > 120 U/ml is generally caused by

Liver, stomach and biliary tree inflammatory bowel disease, bile duct Pregnancy, menstruation, endometriosis, ovarian cysts, fibroids, pelvic inflammatory disease, pancreatitis, cirrhosis, peritonitis, pleural effusion, following surgery or paracentesis

inflammation or blockage of the tumor 0-35 U/ml

CA 27.29 (Carbohydrate marker)

Breast** (best used to detect Colon , gastric, liver, lung, pancreatic, ovarian, prostate cancers

Ovarian cysts, liver and kidney disorders, non-cancerous (benign) breast problems

< 40 U/ml Generally, levels > 100 U/ml signify cancer (30% of patients have elevated CA 27.29 for 30-90 days after treatment, so wait 2-3 months after starting new treatment to check)

antigen 27.29) (blood serum recurrence or metastasis)

Carcinoembryonic antigen

Colorectal cancers ** Breast,

Cigarette smoking, pancreatitis, <2.5 ng/ml in nonhepatitis, inflammatory bowel smokers <5 ng/ml in smokers Generally, > 100 signifies metastatic cancer Normal 6-10 mg over 24 hours

(CEA) (blood serum marker) lung, gastric, pancreatic,

bladder, kidney, thyroid, head disease, peptic ulcer disease, & neck, cervical, ovarian, liver, hypothyroidism, cirrhosis, lymphoma, melanoma 5-HIAA (5-Hydroxy-Indol Acetic Acid) (24 hour urine collection) Carcinoid tumors COPD, biliary obstruction Celiac & tropical sprue, Whipple's disease, dietary: walnuts, pecans, bananas, avocados, eggplants, pineapples, plums & tomatoes; medications: acetaminophen, aspirin and guaifenesin Lactic dehydrogenase (LDH) Lymphoma, melanoma, acute Hepatitis, MI (heart attack), (blood serum marker) leukemia, seminoma (germ cell tumors) stroke, anemia (pernicious & thalassemia), muscular dystrophy, certain medications (narcotics, aspirin, anesthetics, alcohol), muscle injury NMP 22 (urinary marker) PAP (Prostatic acid phosphatase) (blood serum marker) PSA (Prostate specific antigen) Bladder cancer** Metastatic prostate cancer** Myeloma, lung cancer, osteogenic sarcoma Prostate BPH (benign prostatic hypertrophy), prostatitis Prostatitis, Gaucher's disease, osteoporosis, cirrhosis, hyperparathyroidism, prostatic hypertrophy BPH (benign prostatic hypertrophy), nodular prostatic hyperplasia, prostatitis, prostate trauma or inflammation Urine Catecholamines:VMA Neuroblastoma** (Vanillylmandelic Acid) (24 catecholamine metabolite) Pheochromocytoma, rhabdomyosarcoma, PNET hour collection of urine; it is a ganglioneuroma,

Normal values are 100-333 u/l

Normal < 10 U/ml Normal : 0.5 to 1.9 u/l

Normal < 4 ng/ml (half life 2-3 days)

Dietary intake (bananas, vanilla, 8 35 mmols over 24 tea, coffee, ice cream, chocolate), medications (tetracyclines, methyldopa, MAOIs) Same as VMA, in addition: psychosis, major depression, dopamine (a medication) Up to 40 mmols over 24 hours hours

HVA (homovanillic acid) (24 Neuroblastoma** hour collection of urine; it is a catecholamine metabolite)