Tumours and suitable tumour markers

Material
Serum, exceptions specified in brackets

Tumour Suitable individual markers Additional diagnostics Recommended combination
Anal cancer
(squamous cell carcinoma)
SCC, CEA, CA 50, p53   SCC + CEA
Lung cancer     CYFRA 21-1 + NSE
  • Small cell
NSE, ProGRP, TPA, chromogranin A, CEA, M2-PK ACTH, calcitonin, CYFRA 21-1, TPA NSE + ProGRP
  • Squamous cell carcinoma
SCC, CYFRA 21-1, CEA, M2-PK CA 72-4, ACTH, TPA CYFRA 21-1 + CEA
  • Adenocarcinoma
CYFRA 21-1, CEA, M2-PK, CA 50 CA 72-4, ACTH, TPA CYFRA 21-1 + CEA
Biliary cancer CA 19-9, CEA, AFP, CA 72-4 CA 50, CYFRA 21-1, p53, CA 125 CA 19-9 + CEA
Urinary bladder cancer CYFRA 21-1, NMP22 (urine) TPA, CEA CYFRA 21-1 + NMP 22
Brain tumour CEA (CSF + serum), S100,
thymidine kinase (CSF)
NSE (CSF) CEA + thymidine kinase (serum + CSF)
Pituitary adenomas TSH + fT3/4; GH + IGF1
LH/FSH + testosterone/oestradiol
ACTH + Cortisol; prolactin
   
Germ cell tumours   LDH, M2-PK, p53, TPA AFP + ß-HCG + PLAP
  • Seminomas
NSE, PLAP   NSE + PLAP
  • Non-seminomas (except for teratomas)
AFP, ß-HCG, PLAP, SCC   AFP + ß-HCG
Bone metastases Ostase (= bone AP), bone TRAP, cross-links (urine) Hydroxyproline, TPA, p53 Ostase, bone TRAP
Colorectal cancer CEA, CA 19-9, CA 50, p53, TPA, CA 72-4, M2-PK (stool) LDH CEA + CA 19-9
Head and neck tumours SCC, CEA, p53, TPA   SCC + CEA
Leukaemia Blood count (EDTA), LDH, immunophenotyping (EDTA) Immunoglobulins, ferritin, vit. B12, LDH Blood count + immunophenotyping
Lymphomas Blood count (EDTA), LDH, immunophenotyping (EDTA) Immunoglobulins, LDH Blood count + immunophenotyping
Hepatocellular carcinoma AFP, CEA, CA 19-9, CA 125 Ferritin, TPA, p53 AFP
Gastric cancer CEA, CA 19-9, CA 50, CA 72-4, M2-PK (serum + stool), CA 125 Ferritin, TPA, LDH CEA + CA 19-9
Breast cancer CA 15-3, CEA, TPA, HER-2 LDH CEA + CA 15-3
Melanoma S 100, NSE (CSF), LPA, sialic acid (= LSA), 5-S-cysteinyldopa Melanin, MIA, LDH, melanogen (urine), TPA S100
Multiple myeloma Immunoglobulins, paraproteins ß2-microglobulin S100
Neuroblastoma NA, dopamine, NSE, homovanillic acid (urine), vanillylmandelic acid LDH NSE
Renal cell carcinoma TPA, CEA, neopterin, M2-PK Erythropoietin, renin, ferritin M2-PK + CEA
Oesophageal cancer (squamous cell carcinoma) CEA, SCC, CA 19-9, M2-PK CA 50 SCC + CEA
Osteosarcoma Ostase (= bone-AP), hydroxyproline, CEA, TPA    
Ovarian cancer     CA 125 + CA 72-4
  • Epithelial
CA 125, CASA, CA 15-3, CEA TPA CA 125 + CA 72-4
  • Mucinous
CA 72-4, CA 125, CEA, CA 19-9, CA 50 TPA CA 125 + CA 72-4
  • Serous / endometrioid
CA 125, HE4 TPA CA 125 + HE4, ROMA
Pancreatic cancer CA 19-9, CA 50, CEA, CA 72-4 M2-PK, TPA CA 19-9 + CEA
Prostate cancer PSA, free PSA, PCA3, P53 TPA, CEA, LSA PSA + free PSA (PCA) 3
Thyroid cancer     CEA
  • Papillary, follicular
Thyroglobulin, CEA TPA Thyroglobulin + CEA
  • Medullary (C cell carcinoma)
CEA, NSE, calcitonin TPA Calcitonin + CEA
Uterine cancer      
  • Squamous epithelium
TPA, CEA, SCC   SCC + CEA
  • AdenoCA
CA 125, CEA, TPA, CA 19-9 CA 50, CA 15-3 TPA + CEA
  • ChorionCA
ß-HCG, AFP   ß-HCG + AFP
Vulvar cancer SCC, CEA    
Cervical cancer SCC, CEA, CYFRA 21-1, CA 125 TPA SCC + CEA
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