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Tumor markers can be molecules that are produced in higher amounts by cancer cells than normal cells, but can also be produced by other cells from a reaction with the cancer. [ 2 ] The markers can't be used to give patients a diagnosis but can be compared with the result of other tests like biopsy or imaging.
There were four factors found to have independent prognostic relevance: age, performance status, LDH, and white blood cell count (WBC). [4] The point values are assigned as follows: 0 points: Age less than 50 years, ECOG performance status of 0–1, LDH less than 0.67 of the upper limit of normal, or WBC of less than 6,700 cells/mcl
This tumor marker can be detected in the blood, saliva, or urine. [17] The possibility of identifying an effective biomarker for early cancer diagnosis has recently been questioned, in light of the high molecular heterogeneity of tumors observed by next-generation sequencing studies. [23]
The Ki-67 score closely correlates with other proliferation markers, and has been shown to have prognostic and predictive value for many different tumor types. [9] Similarly, proliferating cell nuclear antigen (PCNA) is a protein associated with cell proliferation that is upregulated in proliferating cells, making it another useful antigen for ...
G (1–4): the grade of the cancer cells (i.e. they are "low grade" if they appear similar to normal cells, and "high grade" if they appear poorly differentiated) S (0–3): elevation of serum tumor markers; R (0–2): the completeness of the operation (resection-boundaries free of cancer cells or not) Pn (0–1): invasion into adjunct nerves
Therefore, the utilization of such techniques for objective tumor response should be restricted to validation purposes in specialized centers. However, such techniques can be useful in confirming complete pathological response when biopsies are obtained. Tumor markers alone cannot be used to assess response.
A panel of epigenetic methylation marker has been explored for prognosis of ovarian cancer, and it is reported that the panel exhibited high specificity and sensitivity (both above 70%) as a screen marker. [5] Epigenetic markers have also shown promising potential as prognostic markers for bladder cancer. [6]
Grading in cancer is distinguished from staging, which is a measure of the extent to which the cancer has spread. Pathology grading systems classify the microscopic cell appearance abnormality and deviations in their rate of growth with the goal of predicting developments at tissue level (see also the 4 major histological changes in dysplasia ).