Blog

Bakhtiar Alam: Tumor markers are not specific to cancer

Bakhtiar Alam/LinkedIn

Mar 24, 2025, 18:21

Bakhtiar Alam: Tumor markers are not specific to cancer

Bakhtiar Alam, Head Technologist at Shifa International Hospitals Limited, shared on LinkedIn:

” Tumor Markers

Tumor markers are substances that are produced by tumor or cancer cells, or by other cells in response to a tumor or cancer. They can be found in the blood and other body fluids. However, tumor markers are not specific to cancer and can also be expressed by healthy tissues, although in much lower concentrations.

Tumor markers can be classified into different categories:

Remembering the different categories of tumor markers can be made easier by using a mnemonic like “HOLD ME,” which stands for Hormones, Onco-fetal antigens, Lineage-specific proteins, DNA markers, Mucins and other glycoproteins, and Enzymes.

CLASSIFICATION

Hormones:
Certain cancers can cause high levels of hormones in the body, which can be used as diagnostic or prognostic indicators.
Examples:
Human chorionic gonadotrophins (elevated in trophoblastic tumors),
Calcitonin (elevated in medullary carcinoma of the thyroid), and
Catecholamines (elevated in pheochromocytoma).
Onco-fetal antigens:
These antigens are normally expressed during fetal development but can be reactivated or expressed at higher levels in certain cancers.
Examples:
Alpha-fetoprotein (elevated in liver cell cancers) and
Carcinoembryonic antigen (CEA, elevated in colon and other cancers).
Lineage-specific proteins:
These proteins are expressed in a cell lineage or cell type-specific manner and can help identify the tissue of origin in metastatic cancers.
Examples:
Prostate-specific antigen (PSA, elevated in prostate cancer) and monoclonal immunoglobulins, M protein (elevated in multiple myeloma and other plasma cell disorders).
DNA markers (cell-free):
Circulating tumor DNA markers are fragments of DNA that contain specific genetic alterations or mutations found in cancer cells.
Examples include
Epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer and
K-RAS mutations in colorectal and pancreatic cancers.
BRAF V600E mutation in Melanoma and papillary thyroid cancer
Mucins and other glycoproteins:
These markers are glycoproteins that can be modified or show altered expression in cancer cells.
Examples include,
CA125 (elevated in ovarian cancer) and
CA19-9 (elevated in colorectal and pancreatic cancers).
CA 15-3 ( Breast cancer )
Enzymes:
Certain enzymes can be elevated in cancer and used as tumor markers.
Examples include,
Lactate dehydrogenase (elevated in lymphoma, leukemia, and germ cell tumors) and
Alkaline phosphatase (elevated in liver cancer and bone metastasis).”