Deck 24: Tumor Markers

Question 1

In which of the following disorders would the maternal serum level of ?₁-fetoprotein be elevated?

A) Neural tube defect
B) Cardiac ischemia
C) Down syndrome
D) Small cell lung carcinoma

Answer 1

Neural tube defect

Question 2

Which of the following statement is correct about PSA?

A) It is a cystine protease.
B) It is large globular protein.
C) It is a single-chain glycoprotein consisting of 237 amino acids.
D) It complexes with apoprotein C.

Answer 2

It is a single-chain glycoprotein consisting of 237 amino acids.

Question 3

Which of the following biomarkers is elevated in nonmucinous epithelial ovarian cancer?

A) CA 15-3
B) CA 19-9
C) CA 125
D) CEA

Answer 3

CA 125

Question 4

Which of the following is a sialylated Lewis blood group antigen associated with colorectal cancer?

A) CA 125
B) CA 15-3
C) PSA
D) CA 19-9

Question 5

Which of the following biomarkers are elevated in advanced stages of breast cancer?

A) Total and free PSA
B) CEA and alpha-fetoprotein
C) CA 15-3 and CA 549
D) DUPAN-2 and Gastrin

Question 6

Which tumor marker is associated with cancer of the urinary bladder?

A) CA 125
B) CA19-9
C) CA 50
D) Nuclear matrix protein

Question 7

What is the clinical usefulness of measuring carcinoembryonic antigen?

A) Diagnosis of lung cancer
B) Diagnosis of colorectal cancer
C) Screening for breast cancer
D) Monitoring for recurrence of colon cancer

Question 8

Which of the following is used to assess the usefulness of trastuzumab (Herceptin) therapy for breast cancer?

A) CA 15-3
B) HER-2/neu
C) CA 125
D) Prolactin

Question 9

Which type of hCG test would be most useful to assess a person suspected of having testicular cancer?

A) Plasma immunoassay for intact hCG and the ?-hCG subunits
B) Plasma immunoassay for the free alpha and ?-hCG subunits
C) Urine assay for hCG-? core
D) Plasma immunoassay for intact hCG only

Question 10

A markedly elevated serum AFP is associated with which of the following?

A) Ovarian cancer
B) Lung cancer
C) Hepatoma
D) Breast cancer

Question 11

Which of the following assays is recommended as a screening test for colorectal cancer in persons over 50 years of age?

A) Fecal typsin
B) AFP
C) BTA
D) Occult blood test

Question 12

Which of the following must be determined to calculate diagnostic specificity?

A) True-negatives and false-positives
B) True-positives and false-positives
C) True-positives and false-negatives
D) True-negatives and false-negatives

Question 13

A new tumor marker assay for prostate specific antigen (PSA) is evaluated for diagnostic sensitivity by testing serum samples from patients who have been diagnosed as having prostate cancer. The following results were obtained:
Number of prostate cancer patients who tested positive by the new assay = 42 out 46
Number of patients who did not have cancer and tested negative by the new assay = 31 out of 32
What is the sensitivity of the new assay for PSA?

A) 98.0%
B) 95.0%
C) 91.3%
D) 88.5%

Question 14

Which statement below best describes the molecular difference between free PSA (fPSA) and complex PSA (cPSA)?

A) Free PSA is bound by compounds such as ACT, PCI, API, or AMG.
B) Free PSA is an active form that can complex with protease inhibitors.
C) Free PSA is not bound by compounds such as ACT, PCI, API, or AMG.
D) Free PSA cannot be detected in serum, whereas complex PSA can.

Question 15

The production of alpha fetal protein (AFP) in a healthy individual is best reflected by which of the following statements?

A) The production of AFP remains the same through life.
B) The production of AFP increases rapidly at birth and healthy adults and children have negligible or undetectable levels in serum.
C) The production of AFP declines rapidly at birth and healthy adults and children have higher than normal levels in serum.
D) The production of AFP declines rapidly at birth and healthy adults and children have negligible or undetectable levels in serum.

Question 16

The combination of squamous cell carcinoma antigen (SCCA) and CYFRA 21-1 test results can be used to provide reliable laboratory data for the differential diagnosis of which disease?

A) Nonsquamous cell lung carcinoma
B) Pancreatic cancer
C) Liver cancer
D) Pulmonary embolism

Question 17

A new test for breast cancer is found to have a sensitivity of 85.0% and a specificity of 90.0%. If the prevalence of breast cancer is 3.5% in women over 45 years old, what is the predictive value of a positive test result (PV+) in this group?

A) 60.0
B) 50.5
C) 30.0
D) 23.6

Question 18

Nuclear matrix protein-22 (NMP) is a tumor marker designed for what purpose?

A) Test for recurrence of bladder cancer
B) Test for recurrence of lung cancer
C) Test for recurrence of bone cancer
D) Test for recurrence of colorectal cancer

Question 19

Which molecular form(s) is/are measured by an intact ?-hCG assay?

A) hCG core and "nicked" hCG or hCGn
B) The whole molecule
C) Only "nicked" hCG or hCGn
D) ?-hCG and free ?-hCG subunits

Question 20

Diagnostic specificity is defined as which of the following?

A) The probability that a laboratory test will be positive in the absence of disease
B) The probability that a laboratory test will be negative in the absence of disease
C) A measure of how often the assay system detects the biomarker when the disease is present
D) The probability that a disease is present when the test is positive or that a disease is absent when a test is negative