Expansion
Most are for monitoring rather than diagnosis or screening
Expansion
| Marker | Associated malignancy | Also raised in |
|---|---|---|
| PSA | Prostate | Benign hyperplasia, prostatitis, instrumentation |
| CA-125 | Ovarian | Endometriosis, menstruation, ascites, pregnancy |
| CA 19-9 | Pancreatic, biliary | Cholestasis of any cause |
| CEA | Colorectal | Smoking, inflammatory bowel disease |
| AFP | Hepatocellular, non-seminomatous germ cell | Pregnancy, hepatitis |
| beta-hCG | Germ cell, choriocarcinoma | Pregnancy |
| Calcitonin | Medullary thyroid | |
| Thyroglobulin | Differentiated thyroid, for follow-up | |
| Paraprotein | Myeloma | MGUS |
Two are used for germ cell tumours together: AFP and beta-hCG. A pure seminoma does not produce AFP, so a raised AFP indicates a non-seminomatous element regardless of histology, which changes treatment.
Calcitonin is one of the few used diagnostically, in medullary thyroid carcinoma and its screening in MEN2 families.
The general principle is that these markers lack the sensitivity and specificity for population screening, and are most useful for monitoring response and detecting recurrence in a patient with a known tumour that was marker-positive at diagnosis.