Laboratory for Patients at Risk of Multiple Primary Malignancies

  • Marcello Caggiano
  • Angela Mariano
  • Massimiliano Zuccaro
  • Sergio Spiezia
  • Marco Clemente
  • Vincenzo Macchia
Part of the Updates in Surgery book series (UPDATESSURG)


Biomarkers are a useful laboratory diagnostic approach for the non-invasive early detection of disease and recurrent disease. An ideal tumor marker is a protein or protein fragment that can be easily detected in the patient’s blood or urine, but is not detectable in healthy people. The first of such biomarkers to be used in laboratory testing was carcinoembryonic antigen (CEA), introduced in 1965. Other biomarkers currently in use are CA 19-9 (gastrointestinal tumors), CA125 (ovarian cancer), Ca 15-3 (breast cancer). However, while the levels are very low in healthy people they become substantially elevated only when a considerable amount of cancer is present. Moreover, these markers are for the most part not specific for a single tumor. Women with breast cancer or gynecological disease may have elevated CEA and CA 125. Another cancer biomarker, and perhaps the best known one, is prostate-specific antigen (PSA), which allows for the early detection of prostate disease. The serum PSA test is used in screening programs for prostate cancer and has brought about a dramatic increase in early detection of the disease. Nonetheless, for most cancers biomarkers with high specificity and sensibility are lacking, which limits our ability to screen the majority of tumors. PSA, for example, is very sensitive but has low specificity. It remains the only tumor biomarker certified by the US Food and Drug Administration for widespread screening, which is carried out along with digital rectal examination. Technological advances in genomic and proteomics have produced candidate markers with screening potential.


Ovarian Cancer Epithelial Ovarian Cancer Lynch Syndrome Medullary Thyroid Carcinoma Islet Cell Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Marcello Caggiano
    • 1
  • Angela Mariano
    • 2
  • Massimiliano Zuccaro
    • 1
  • Sergio Spiezia
    • 3
  • Marco Clemente
    • 1
  • Vincenzo Macchia
    • 2
  1. 1.Surgical, Anesthesiology-rianimative and Emergency Sciences DepartmentFederico II UniversityNaplesItaly
  2. 2.Department of Clinical Pathology, Faculty of MedicineFederico II UniversityNaplesItaly
  3. 3.Unit of Screening and Follow-up for Hereditary and Familial Cancer, Department of Molecular and Clinical Endocrinology and OncologyFederico II UniversityNaplesItaly

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