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Protein Tumor Markers

Biomarkers that are produced at higher levels in cancerous conditions compared to benign conditions are collectively termed tumor markers. Most but not all of these substances are proteins that can be measured in body fluids, tumors, or other tissues depending on the kind and the stage of various cancerous conditions.

What are biomarkers

Biomarkers are defined as “any substance, structure, or process that can be measured in the body or its products and influence or predict the incidence of outcome or disease”1. Certain physiological conditions are characterized by the presence or altered levels of substances specific for that condition. Substances such as proteins and peptides can be readily measured and are therefore often times used as biomarkers.


Biomarkers in tumor diagnostics

Tumor markers represent a subset of biomarkers that are indicative for cancerous growth. Most of these marker are being produced by both normal cells as well as tumor cells. The levels at which they are present in bodily fluids like urine, saliva or blood are however typically significantly higher in patients with various malignancies.

There is a plethora of tumor markers2, 3 being used which can be classified base on their function, the way they are detected, or the kind of sample in which they are measured:

  • Oncofetal antigens
  • Tumor associated antigens
  • Hormones and hormone receptors
  • Enzymes and isoenzymes
  • Serum and tissue proteins
  • Cancer stem cells4
  • other tumor markers such genetic markers and biomolecules.

cancer types

A perfect tumor marker is highly specific and differentiates reliably between healthy individuals and cancer patients. It can be a universal tumor marker or specific for one particular malignancy. It should permit early detection of early stage tumors and at the same time distinguish tumor stages and have prognostic value for outcome and potential recurrence. Lastly, it should be easily measureable with established techniques to follow any changes during the course of a treatment.

None of the established markers fulfill all the points in the wish list for the perfect tumor marker. Instead, several markers are typically used in conjunction to allow for a reliable diagnosis, prognosis, staging and monitoring of a wide range of different cancer types5.


How to measure tumor markers

Presently, the majority of tumor biomarkers are proteins or peptides. Consequently, they can be qualitatively and quantitatively measured using immunological methods such as ELISA, immunohistochemistry, immunofluorescence, flow cytometry, or other methods depending on the nature of the marker and of the sample.

An increasing number of tumor markers are also based on genetic variations6. Altered expression patterns and mutations in certain oncogenes do not affect the type of malignancy but are also determinants for the response to treatment.


cancer types

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Tumor marker related products

Marker class Marker - click antigen for available products Gene Cancer type IV
Oncofetal antigensAFPliver, germ cell tumors, ovarian, testicular
Oncofetal antigensCEACAM5esophageal, bile duct, colorectal, breast, thyroid
Oncofetal antigensCEACAM6esophageal, bile duct, colorectal, breast, thyroid
Oncofetal antigensCEACAM1esophageal, bile duct, colorectal, breast, thyroid
Oncofetal antigensCEACAM7esophageal, bile duct, colorectal, breast, thyroid
Tumor associated antigens-carcenoid
Tumor associated antigensMUC1breast
Tumor associated antigens-pancreatic, gallbladder, bile duct, gastric
Tumor associated antigensMUC1breast
Tumor associated antigens-bile duct, gastric cancer
Tumor associated antigensMUC16ovarian
Hormes and receptorsCGA, CGBchoriocarcinoma, testicular
Hormes and receptorsCalcitoninCALC1medullary thyroid cancer
Hormes and receptorsCHGAneuroendocrine tumors
Hormes and receptorsEGFR mutation analysisEGFRnon-small cell lung cancer
Hormes and receptorsESR1breast
Hormes and receptorsESR2breast
Hormes and receptorsHER2/neuERBB2breast, gastric, esophageal
Hormes and receptorsBGLAPbone
Hormes and receptorsProgesterone receptor (PR)PGRbreast
Hormes and receptorsTFRCbreast
Hormes and receptorsTTRovarian
Enzymes and modulatorsAlkaline phosphatase (BAP)ALPLbone
Enzymes and modulatorsBCR-ABL fusion geneBCR/ABL1chronic myelogenous leukemia, acute lymphoblastic leukemia, acute myelogenous leukemia
Enzymes and modulatorsBRAF V600EBRAFCutaneous melanoma and colorectal cancer
Enzymes and modulatorsKITKITgastrointestinal stromal tumor, mucosal melanoma
Enzymes and modulatorsKRAS mutation analysisKRAScolorectal, non-small cell lung cancer
Enzymes and modulatorsPSAprostate
Enzymes and modulatorsLDHAgerm cell tumors, gastric
Enzymes and modulatorsLDHBgerm cell tumors, gastric
Enzymes and modulatorsLactate dehydrogenaseLDHCgerm cell tumors, gastric
Enzymes and modulatorsENO2lung
Enzymes and modulatorsNUMA1bladder
Enzymes and modulatorsplasminogen activator inhibitor (PAI-1)SERPINE1breast
Enzymes and modulatorsSERPINB3esopahgeal, lung, ovarian, squamous cell carcinoma
Enzymes and modulatorsSERPINB4esopahgeal, lung, ovarian, squamous cell carcinoma
Enzymes and modulatorsPLAUbreast
Serum and tissue proteinsApolipoprotein A1APOA1ovarian
Serum and tissue proteinsB2Mmultiple myeloma, chronic lymphocytic leukemia, lymphoma
Serum and tissue proteinsKRT19breast, lung
Serum and tissue proteinsWAP5ovarian
Serum and tissue proteinsFerritinFTL, FTH1liver
Serum and tissue proteinsfibrinogen-bladder
Serum and tissue proteins-bladder
Serum and tissue proteinsS100S100A1malignant melanome
Serum and tissue proteinsTissue polypeptide antigen (TPA)-lung
Serum and tissue proteinsTGthyroid
Cancer stem cellsALDH1A1cancer stem cells, breast, colon, lung, melanoma, pancreatic, prostate
Cancer stem cellsMS4A1Cancer stem cells, Non-Hodgkin lymphoma, melanoma
Cancer stem cellsCD24Cancer stem cells, colon cancer
Cancer stem cellsCD44Cancer stem cells, breast, colon, liver, ovarian, pancreatic, prostate
Cancer stem cellsNESCancer stem cells, glioma, pancreatic


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