Unifying Concepts

Tumor Markers in Clinical Practice

Tumor markers are playing an increasingly important role in cancer detection and management. These laboratory-based tests are potentially useful in screening for early malignancy, aiding cancer diagnosis, determining prognosis, surveillance following curative surgery for cancer, up front predicting drug response or resistance, and monitoring therapy in advanced disease.

Tumor Markers in Clinical Practice
Biomarkers that have undergone or are currently undergoing evaluation in screening asymptomatic subjects for cancer

  • Colorectal: FOBT (Fecal Occult Blood Testing)
  • Prostate: PSA (Prostate-Specific Antigen)
  • Ovarian: CA 125 (Carbohydrate Antigen 125)
  • Neuroblastoma: VMA/HVA (Vanillylmandelic acid/homovanillic acid)
  • Hepatocellular: AFP (alpha-fetoprotein)
  • Gastric: Pepsinogen
  • Trophoblastic: HCG (Human Chorionic Gonadotrophin)

Markers that may be used for determining prognosis in different cancers

  • Breast: Oncotype DX, uPA/PAI-1 (urokinase-type plasminogen activator / human plasminogen activator inhibitor type 1)
  • Germ cell: AFP, HCG, LDH (Lactate dehydrogenase)
  • Colorectal: CEA (carcinoembryonic antigen), MSI (microsatellite instability)
  • Prostate: PSA
  • Ovarian: CA 125

Serum markers that may be used in postoperative surveillance and monitoring therapy in different cancers

  • Colorectal: CEA
  • Hepatocellular: AFP
  • Pancreatic: CA 19-9
  • Ovarian: CA 125
  • Breast: CA 15-3
  • Prostate: PSA
  • Germ cell: AFP, HCG
  • Lung (non-small cell): Serum Fragment of Cytokeratin Subunit 19 measured by CYFRA 21-1, squamous cell carcinoma (SCC) antigen
  • Lung (small cell): NSE (neuron-specific enolase), Progastrin-releasing peptide (ProGRP)
  • Melanoma: S100
  • Trophoblastic: HCG
  • Thyroid (differentiated): thyroglobulin



  1. Duffy MJ. Tumor markers in clinical practice: a review focusing on common solid cancers. Med Princ Pract. 2013;22(1):4-11. [Medline]
  2. Duffy MJ. Role of tumor markers in patients with solid cancers: A critical review. Eur J Intern Med. 2007 May;18(3):175-84. [Medline]


Created: Mar 11, 2015.

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