Tumour  Markers According  to Tissue of Origin

Breast Cancer                    CA 15.3 ,CA 27.29, CEA, ER and PR

                                                pS2,HER-2/neu, cathepsin D, p53

                                                DNA ploidy , S  phase  , EGFr

Prostate Cancer                Pap, PSA,DNA ploidy, IGFBP-2

Colorectal cancer             CEA, p53

Gastric Cancer                   CA 72 ,4,CEA

Pancreatic cancer             CA19.9,CEA ; glucagon ;insulin proinsulin,C-peptide and IGFBP-1

Liver cancer                        AFP, CEA , ferritin

Lung cancer                        Cyfra-21 ;neuron specific enolase

Ovarian cancer                  CA 125, CEA ;urinary gonadotropin peptide inhibin

Cervical cancer                  HPV, squamous cell carcinoma antigen

Trophoblastic

Cancer                                  Beta hCG

Testicular cancer              AFP

Urinary Bladder                DNA ploidy , S- phase

Cancer

Thyroid cancer                  Calcitonin ; thyroglobulin

Head and Neck 

Cancer                                  Squamous cell carcinoma antigen

Neuroblastoma                                N- mye oncogesne, neuron specific enolase, HVA

Pheochromocytoma       Chromagranin A, VMA

                                                Catecholamines , metanephrines

Paraneplastic                     Neuronal nuclear antibodies , Purkinje cell antibodies, Voltage gated

                                                Syndromes calcium channel antibodies

 Alpha Fetoprotein (AFP)

AFP is one of the best known oncofetal antigens . It is elevated in 80% of patients with hepatocellular carcinoma and 60-80% of patients with testicular germ cell tumours. About 55-100% cases of yolk sac tumours are AFP positive. This fact is helpful in distinguishing  solid patterns of yolk sac tumours from seminomas as the seminomas are AFP negative . False positive results have been noticed in many non-neoplastic conditions like cirrbosis massive liver necrosis chronic hepatitis etc. Plasma AFP is elevated to a lesser extent in carcinomas of colon lung and pancreas. In early stages its level correlates with tumour size .Except pregnancy levels high 1000 ug/L indicate cancer. The AFP levels decline rapidly after surgical resection of liver cancer or treatment of germ cell  tumours. Serial post therapy measurements of AFP provide a sensitive index of response sensitive index of response to therapy and recurrence good prognostic indicator of survival . AFP can be used for screening in high risk cases.

Alpha Subunit

This test is used as a tumour marker in the diagnosis and management of pituitary placental and pancreatic tumours. The various pituitary hormones like TSH, FSH and LH have identical alpha subunits but unique beta subunits.. Measurement of alpha subunit is useful in differentiating TSH secreting pituitary  adenomas from thyroid hormone resistance syndromes. The ratio of alpha subunit to intact TSH in serum is >1 in cases of TSH secreting pituitary adenomas.

Increased levels – Seen in choriocarcinoma , hydatiform mole, pituitary adenomas and pregnancy .

Decreased levels – seen in hypopituitarism