Perspectives of tumour markers in clinical oncology in the era of personalized medicine

• Published in: Indian journal of clinical biochemistry 2016-12, Vol.31 (S1), p.S3
• Main Author: Gopinath, K.S
• Format: Article
• Language: English
• Subjects: CEA (Oncology); Colorectal cancer; Diagnosis; Genetic markers; Pancreatic cancer
• ISSN: 0970-1915

Introduction: Tumour markers are substances that can be detected in higher-than-normal amounts in the blood, urine, or body tissues of some patients with certain types of cancer. Most tumour markers can be elevated in patients who do not have a tumour; and, no tumour marker is entirely specific to a particular type of cancer. The carcinoembryonic antigen (CEA) is one of the first Tumour markers identifi ed in making the diagnosis of colorectal cancer. Gastrointestinal (GI) malignancies including pancreatic cancers have begun to rise in Asia. There is an alarming rise in the incidence of GI malignancies in our country. According to the PBCR, incidence of colorectal cancer in males is 2.92 and 2.30 [1] in females in Bangalore. The common question posed to the surgeon is--is there a marker in tissue or serum which detects the presence of malignancy without being an invasive procedure? Whether absence of the marker post-treatment ensures "cure"? There is an increasing incidence of GI cancers as per the Cancer Registry Data. In such a situation, it is essential to evaluate the patient by standard investigational tools like clinical examination and endoscopy which help in establishing the diagnosis. Determination of tumour markers is useful not only in diagnosis and prognosis of cancer but also monitoring of cancer treatment. Tumour markers in GI oncology include oncofoetal proteins, hormones, enzymes and cancer antigens. Recent advances include application of tumour marker level determination combined with newer radiological and functional imaging such as FDG PET--CT. Conclusion: The biological markers are gaining more importance in the management of various GI malignancies. The serum markers like CEA, LDH, AFP chromo granin etc are helping in diagnosis, prognosis, monitoring of therapy. No Tumour markers are useful in screening. No proper evidence regarding when to do, how often to do, in various malignancies. The genetic markers have remained an investigative methodology for screening, diagnosis, prognosis. This has been very useful in high risk group hereditary cancers syndrome like HNPCC.