Tumor Marker Selection and Interpretation
Context-Dependent Tumor Marker Selection
- The European Society for Medical Oncology recommends that a basic tumor marker workup should include AFP and β-hCG in males with suspected germ cell tumors, PSA in males with possible prostate cancer, CA15-3 and CA125 in females with suspected gynecological primaries, CEA, CA19-9, and CA72-4 when a gastrointestinal primary is suspected, and chromogranin A in patients with possible neuroendocrine malignancy 1, 2
- For males with suspected germ cell tumors, the National Comprehensive Cancer Network recommends using α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) as tumor markers 1, 2, 3, 4
- For males with possible prostate cancer, the American Urological Association recommends using Prostate-specific antigen (PSA) to identify hormone-sensitive tumors amenable to specific therapy 1, 2, 3, 4
- For females with suspected gynecological primary, the Society of Gynecologic Oncology recommends using Cancer antigen 15-3 (CA15-3) and Cancer antigen 125 (CA125) as tumor markers 1, 2
- For suspected gastrointestinal primary, the European Society for Medical Oncology recommends using Carcinoembryonic antigen (CEA), Carbohydrate antigen 19-9 (CA19-9), and Cancer antigen 72-4 (CA72-4) to determine disease course and monitor treatment response 1, 2
- For suspected neuroendocrine malignancy, the European Neuroendocrine Tumor Society recommends using Chromogranin A as a tumor marker 1, 2
Basic Laboratory Panel Accompanying Tumor Markers
- The National Comprehensive Cancer Network recommends that a complete blood count (CBC) should be included in the basic laboratory panel accompanying tumor markers 1, 2, 5
- A comprehensive metabolic panel including serum calcium, liver function studies, lactate dehydrogenase (LDH), and serum creatinine should be included in the basic laboratory panel accompanying tumor markers 5, 6