Raised AFP is typically seen with?
Correct Answer: HCC
Description: Ans. C. HCC. (Ref. Robbin's Pathology8th/pg. 666, 695; Harrison-17th/pg. 483, 587, 614)AFP# AFP is a glycoprotein normally synthesized by the fetal yolk sac and several other fetal tissues. Approximately 50% of HCC patients have elevated serum?-fetoprotein.# However, this tumor "marker" lacks specificity, because modest elevations are also encountered in other conditions, such as- cirrhosis,- massive liver necrosis,- chronic hepatitis,- normal pregnancy,- fetal distress or death,- fetal neural tube defects such as anencephaly and spina bifida, and- gonadal germ cell tumors.# Very high levels (>1000 ng/mL), however, are rarely encountered except in HCC.PProstate-specific antigen (PSA)# It is a glycoprotein which is a serine protease.# Its function may be to facilitate liquefaction of semen, but it is a marker for prostatic disease.# It is measured by an immunoassay and the normal range can differ a little from laboratory to laboratory.# The normal upper limit is about 4 nmol/ml.# Its level in men with metastatic prostate cancer is usually increased to >30 nmol/ml and falls to low levels after successful androgen ablation.# Men with locally confined prostate cancer usually have serum PSA levels <15 nmol/ml. Although PSA is a reliable marker for the progress of advanced disease it is neither specific nor sensitive in the differential diagnosis of early prostate cancer and BPH, as both diseases are compatible with PSA in the range of 4-12 nmol/ml.# PSA measurement has superseded measurement of serum acid phosphatase.# PSA is good at following the course of advanced disease.# It is lacking in sensitivity and specificity in the diagnosis of early localised prostate cancer.# Nevertheless, the finding of a PSA >10 nmol/ml is suggestive of cancer and >35 ng/ml is diagnostic of advanced prostate cancer.# A decrease of PSA to the normal range following hormonal ablation is a good prognostic sign.Carcinoembryonic antigen (CEA):# CEA, which is elaborated by carcinomas of the colon, pancreas, stomach, and breast, and ?-fetoprotein, which is produced by hepatocellular carcinomas, yolk sac remnants in the gonads, and occasionally teratocarcinomas and embryonal cell carcinomas.# CEA and?-fetoprotein assays lack both specificity and sensitivity required for the early detection of cancers. They are still particularly useful in the detection of recurrences after excision. With successful resection of the tumor, these markers disappear from the serum.QTumor markers for testicular tumor# hCG: HCG produced by neoplastic syncytiotrophoblastic cells, is always elevated in patients with choriocarcinoma. Other germ cell tumors, including seminoma, may also elaborate hCG. Approximately 10% to 25% of seminomas elaborate hCG.# AFP: RAISED in yolk sac (endodermal sinus) tumor. AFP is a reliable indicator of the presence of a nonseminomatous component to the germ cell neoplasm, because yolk sac elements are not found in pure seminomas. Because mixed patterns are common, most nonseminomatous tumors have elevations of both hCG and AFP.# In addition to the primary diagnosis and staging of testicular germ cell tumors, serial determinations of hCG and AFP is useful for monitoring patients for persistent or recurrent tumor after therapy.TumorMarkersMelanomaHMB45, S-100, TyrosinaseCa PancreasCA 19-9, PIVKANeuroblastomaLDH, Ferritin, Neuron specific enolaseGistc-KITMCTCalcitoninSCLCNeuron specific enolaseOvarian cancer and some lymphomasCA-125Adenocarcinoma of colon, breast, pancreasCEACA-125NeuroblastomaLDHLymphoma Ewing's sarcoma Dysgerminoma Seminoma Gonadal germ cell tumor HCCAFPGonadal germ cell tumorHCG
Category:
Pathology
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