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Duke PA Onc dmethods

Duke PA Oncology diagnostic methods

The ability of a test to rule out a disease Sensitivity
The percentage of people with cancer who will have an abnormal test Sensitiviy
The percentage of people without cancer whose test is negative Specificity
The ability of a test to rule in disease Specificity
Probability that people with an abnormal test actually have cancer Positive predictive value
Probability that a negative test will predict that a person does not have cancer Negative predictive value
Proteins normally found in larger amounts during fetal development Antigens
These are examples of which type of tumor marker; AFP, CEA, PSA, CA-125, Bence Jones Proteins Antigens
These are examples of which type of tumor marker; Prostatic Acid Phosphatase, Galactosyl transferase II Enzymes
This marker is often associated with tumors of endocrine glands Hormones
These are examples of which type of tumor marker; Beta-HCG, Human Calcitonin Hormones
Genes that are useful in fetal development but when activate in mature cells trigger tumor growth Oncogenes
These are examples of which type of tumor marker; BRCA 1, BRCA 2, Philadelphia chromosome Oncogenes
Philadelphia Chromosome is associated with which type of cancer Chronic Myelogenous Leukemia-CML
Cell surface proteins that affect the rate of tumor development by binding to hormones and growth factors Tissue receptors
These are examples of which type of tumor marker; ER assay, PR assay, EGFR Tissue receptors
What goes down as prevalence of disease goes down Positive predictive value
Increased in 80-90% of patients with hepatocellular carcinoma Alpha-Fetoprotein (AFP)
Patients with cirrhosis and active hepatitis should be screened with which tumor marker every 3-4 months Alpha-Fetoprotein (AFP)
Used primarily to detect and monitor clinical course of Multiple Myeloma. It is not found in the blood b/c it is effeciently filtered by the kidneys. Considered to be the first tumor marker. Bence Jones Proteins
This hormone tumor marker is normally negative except in pregnancy, and is never found in cancer free males. Beta-HCG
This hormone tumor marker is primarily associated with the following; Hydatidiform mole of the uterus, chriocarcinoma of the uterus, and germ cell tumors of the ovaries Beta-HCG
High levels of this hormone are almost always pathognomonic for germ cell neoplasm in men. Beta-HCG
This antigen is useful in diagnosis, evaluation of therapy, and sruveillance in patients with pancreatic and hepatobiliary cancer CA 19-9
This antigen is elevated in 80-90% of women with ovarian cancer. CA 125
This antigen is used in determining the extent of disease, prognosis, and response to therapy in patients with GI cancers. Carcinoembryonic Antigen (CEA)
Baseline for this antigen is elevated in smokers. Carcinoembryonic Antigen (CEA)
This antigen is used in screening for early detection of prostate cancer. Prostate Specific Antigen (PSA)
When combined with a digital rectal exam 90% of clinically significant cancers can be detected. Prostate Specific Antigen (PSA)
Not a tumor marker but a useful diagnostic tool for assessing risk of developing breast cancer in a woman in the general population The Gail model
This tool takes into acount these factors when assessing 5 year and lifetime risk of developing breast cancer; current age, age at menarche, previous breast biopsies, age at first live birth, family history of breast cancer. The Gail model
Breast cancer oncogenes BRCA 1, BRCA 2
Men with this mutation carry a markedly increased risk of developing prostate cancer and or colorectal cancer, and may pass the mutation to their daughters. BRCA 2
This tissue receptor indicates sensitivity to hormonal therapy. Estrogen Receptor (ER) assay, and Progesterone Receptor (PR) Assay
Tumors positive for this tissue receptor are more than twice as likely to respond to hormone therapy. ER assay
This tissue receptor is more often positive in postmenopausal breast cancer patients PR assay
An increased level of this antigen is associated with more aggressive breast cancers. HER 2 (neu)
Triple negative tumors have no hormonal target for therapy and are negative for which markers. ER, PR, HER 2
This antigen is elevated in 70-80% of patients with metastatic disease, and is rarely elevated in early stage disease. CA 15-3
This antigen is useful in monitoring response to therapy in metastatic breast cancer patients. CA 27.29
This rare marker is associated with liquid tumors; lymphoma, leukemia, multiple myeloma. Beta2 microglobulin
This rare antigen is not a good screening tool b/c levels can be elevated in UTI, renal calculi, recent urinary surgery Bladder tumor antigen (BTA)
This rare marker is a good screening tool for patients at risk for bladder cancer Nuclear Matrix protein 22 (NMP22)
A sensitive marker for detection of bladder cancer across all disease stages and grades Survivin
This hormone is used to evaluat patients with at risk for/suspected medullary carcinoma of the thyroid. Human Calcitonin
This enzyme is associated with Neuroblastoma, carcinoid, and small cell lung cancer Neuron Specific Enolase (NSA)
This enzyme is primarily used to diagnose, stage, and monitor efficacy of treatment in prostate cancer Prostatic Acid Phosphatase (PAP)
This cancer has a 30% recurrence rate even decades after successful treatment Thyroid cancer
This protein is the primary marker for surveillance of well-differentiated thyroid cancers in postoperative patients. Thyroglobulin
Common tumor marker for ovarian cancer CA 125
k-ras, c-myc, abl, Her2/neu are all examples of what Oncogenes
Genes that once mutated activates the growth pathway Oncogenes
Only one copy needs to be mutated to induce tumorogensis Oncogenes
Genes that normally inhibit growth Tumor suppressor genes
A mutation of these causes a loss of inhibition Tumor suppressor genes
Both copies need to be mutated to lose function Tumor suppressor genes
Classic presentation fo this type of cancer is painless jaundice Pancreatic cancer
Tumor marker for teratoma Alpha-Fetoprotein (AFP)
No meat No treat
Tissue Is the issue
In what scenario do you not need a pathological specimen to initiate treatment Pancreatic mass
A small needle is inserted into the mass and cells are removed for microscopic evaluation Fine needle aspiration
Can be done guided or unguided Fine needle aspiration
This type of biopsy is mainly applied to melanoma Punch biopsy
What type of biopsy is not indicated for suspected melanoma Shave biopsy
Once a tissue diagnosis positive for cancer is obtained what is the next step in treatment of the patient Radiographic staging
Based on the theory that lymphatic spread proceeds through a consistent anatomic network of ducts and nodes based on tumor location Sentinel lymph node biopsy
Looking for hot and blue nodes Sentinel lymph node biopsy
It is recommended that those with this disorder start haveing colonoscopies in their teens Familial adenomatous polyposis (FAP)
Should begin screening 10 years prior to the age of onset in the family member affected with what cancer. Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
Created by: bwyche