Diagnosis of ovarian and testicular cancer with tumor markers

Diagnosis of ovarian and testicular cancer with tumor markers

In the ovaries of a woman and the testes of a man, germ cells are produced, the merging of which produces a zygote. Both of these organs synthesize hormones that are responsible for the human reproductive function and regulate homeostasis. Malignant neoplasms can be formed both in the ovaries and in the testes.

Ovarian cancer tumor markers

Ovarian cancer is one of the leading causes of death for women of reproductive age. The disease often occurs under the guise of non-oncological pathology and has no pathognomonic symptoms that would allow revealing the pathology at an early stage. For this reason, the diagnosis is made, as a rule, in the late stages of the pathological process, when the chances of cure are significantly reduced. Analyzes, by means of which tumor markers of ovarian cancer are determined, allow us to reveal the neoplastic process at the preclinical stage.

These are specific substances, the expression of which occurs as a response of the organism to the invasion of cancer. According to its chemical structure, these are large molecules, in the center of which is located the protein to which carbohydrates or lipids are attached. The molecular weight of a tumor marker macromolecule reaches hundreds of thousands of Daltons.

Ovarian cancer tumor markers begin to be expressed by atypical cells since the onset of cell metaplasia. They get into biological fluids in small quantities, where they can be determined using non-invasive methods. If this marker is raised, then there is every reason to assume the presence of a malignant tumor.

In the ovaries, female hormones are produced, or estrogens, in particular, estradiol. Elevated estradiol levels can occur due to the appearance of a malignant tumor.

For the diagnosis of cancer, as a rule, determine the level of several markers: primary, secondary and additional. In ovarian cancer, CA 125 belongs to the main tumor antigens, HE 4 is secondary, and markers of atypical AFP and CEA cells are added. An important role in the diagnosis of the disease is assigned to the determination of the level of human β-chorionic gonadotropin (β hCG).

If you suspect ovarian cancer, a woman is recommended to undergo a comprehensive examination, including determining the level of such markers:

  • tumor antigen CA 125;
  • once the marker is NOT 4;
  • β hCG (human chorionic gonadotropin);
  • embryonic antigen AFP;
  • marker of malignant tumors CEA;
  • estradiol.

Characteristics of ovarian cancer tumor markers

CA-125 is a glycoprotein that is normally produced in women of reproductive age by the endometrium. This explains the cyclical changes in the concentration of the tumor marker CA-125 in the blood in different phases of the menstrual cycle. During the monthly CA-125 is produced in high quantities. In pregnant women, it can be found in the extract of the placenta, from the sixteenth to the twentieth week of pregnancy – in amniotic fluid. In the first trimester, CA 125 is detected in the serum of a pregnant woman.

HE 4 is expressed in ovarian cancer cells, epithelium of the genitals and upper respiratory tract. With a malignant neoplasm of the ovaries, its concentration increases significantly. The use of tumor markers for ovarian cancer HE 4 for the diagnosis of malignant tumors of the body at an early stage is absolutely justified.

HCG, or human β-chorionic gonadotropin, is a pregnancy hormone. It is normally secreted by the placenta of a pregnant woman. If the level of this antigen rises in the blood of a man or a non-pregnant woman, then we can assume the presence of ovarian or testicular cancer.

AFP (α-fetoprotein) is produced by the liver cells. It does not apply to specific markers. Increasing its level above the upper limit of normal can occur in the presence of a malignant neoplasm in the body of a woman or a man localized in the genitals. Using α-fetoprotein, they evaluate the effectiveness of treatment of genital cancer.

Carcinogenic embryonic antigen (CEA, or CEA) is one of the most widely used tumor markers for ovarian cancer. It is an oncofetal antigen. The fact is that in normal expression of CEA occurs only during fetal development, and after the birth of a child, its production stops. Thus, in the blood of a healthy person, normally, only traces of this tumor marker can be found. The determination of the level of a group of heterogeneous protein compounds that belong to CEA is carried out by an immunometric method.

In the blood of men and women throughout the life of hormone estradiol. In reference values, it regulates the activity of organs of the human reproductive system. Its concentration increases during pregnancy and this is a physiological phenomenon. Elevated estradiol levels may be due to the invasion of cancer cells.

Ovarian tumor markers. Indications for examination, interpretation of research results

  • suspicion of malignant neoplasms;
  • screening the radical removal of ovarian tumors during surgery;
  • monitoring the effectiveness of cancer therapy with anticancer drugs;
  • predicting the course of the disease and determining the likelihood of tumor recurrence.

The reference value of CA-125 in the serum of women is the level not exceeding IU / ml. In pregnant women, it can rise to one hundred milli-units per milliliter of serum.

The upper limit of the norm on the ovarian tumor marker is NOT 4 for women who are in premenopause, is 70 pmol / l, and in menopausal patients it is one hundred picomoles. The level of hCG in men and non-pregnant women should not exceed 6.15 mU / l. The free β-subunit of human chorionic hormone is present in the blood of a non-pregnant woman in a concentration that should not exceed 0.013 mIU / ml. The normal concentration of ACE is in the range from 5 to 10 IU / ml.

The level of CEA depends on whether a person smokes cigarettes and abuse alcohol. So, in people who do not have cancer, its concentration is rarely higher than 3 ng/ml. CEA antigen in benign tumors and the ovarian cyst is produced in a slightly increased amount, and the concentration can be increased to 5-10 ng/ml. The CEA level of 7-10 ng/ml is typical for patients suffering from alcoholism, and in smokers, it rises to 10-20 ng/ml. Twenty percent of women suffering from cancer of the uterus showed an increased level of CEA. If patients have metastases, the increase in the level of this tumor marker of ovarian cancer rises in sixty percent of cases.

In patients with ovarian cancer, CEA concentration increases in twenty-five percent of cases. If women have metastases, the level of CEA will be increased by sixty percent of cases. With a persistent increase in the level of CEA in patients during adjuvant cancer therapy of appendages, it can be assumed that there is no adequate response to treatment. If, after the treatment, the concentration of CEA increases again, then it can be assumed that within a few months there will be a relapse of the disease.

Normal estradiol levels in non-pregnant women range from 40 to 161 pmol / l. In postmenopausal women, it should not be above 73 pmol / l. Tumor markers with an ovarian cyst can also be produced in excess.

Tumor cancer test markers

Hermiogenic tumors of the testicle are characterized by a malignant asymptomatic course. For their diagnosis, mainly three testicular tumor markers are used: α-fetoprotein (AFP), free β-hCG subunit and lactate dehydrogenase (LDH).

AFP (α-fetoprotein) is a glycoprotein. In adult patients and children older than one year, the upper limit of the normal level of AFP in serum is 15 mg/ml. Its expression occurs in the elements of the endodermal sinus. In men, a sign of testicular cancer is also an increase in the concentration of human chorionic hormone.

LDH (lactate dehydrogenase) is an enzyme whose synthesis occurs in smooth, cross-striped and cardiac muscles. This tumor marker of testicular cancer is determined in combination with other tumor antigens. A real sign of a malignant neoplasm of the testicle can be considered an increase in LDH levels of more than two thousand units per liter of serum. The increase in the level of testicular tumor markers AFP and CG in some cases indicates the progression of the pathological process six months before the appearance of clinical signs of relapse.

Only the study of a few markers has diagnostic value for cancer of the testicles or ovaries. Diagnosis of malignant neoplasms of the reproductive organs of both men and women should be carried out with the help of a comprehensive examination.

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