Hormones as Tumor Markers

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The page below is a sample from the LabCE course Tumor Markers. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Hormones as Tumor Markers

Because hormones produced by malignant tumors are often identified and quantified by immunoassays designed to measure typically produced hormones, elevation of a given hormone is not considered diagnostic of a specific tumor. While these assays are highly sensitive, their lack of specificity limits their utility as a screening tool.
HormoneType of CancerComments
Adrenocorticotropic hormone (ACTH)Lung (small cell)ACTH is usually produced by the corticotropic cells of the anterior pituitary. It may be accompanied by excessive production of cortisol, traditionally associated with Cushing’s syndrome.
Antidiuretic hormone (ADH)Lung (small cell), adrenal cortex, pancreatic, intestine ADH helps to regulate water balance in the blood. Typically, ADH is elevated in response to high blood osmolality. Measuring ADH about plasma osmolality increases its sensitivity as a tumor marker.
CalcitoninThyroid, lung, breast, renal, liverThey are secreted in response to increased serum calcium to inhibit calcium release from bone.
GastrinGastrinomaFasting plasma gastrin is often significantly increased to several times the standard upper limit. Considered diagnostic as a tumor marker when elevated 10 times the upper limit of normal in the presence of gastric hypersecretion.
GlucagonGlucagonoma (islet-cell pancreatic tumor Highly metastatic. Feedback mechanisms do not control sustained elevated glucose levels as glucagon is produced.
Human chorionic gonadotropin (hCG)Embryonal, placenta, testicular, choriocarcinomaThey are typically elevated during pregnancy. hCG is produced and is highly elevated in trophoblastic or chorionic tumors of embryonic cell origin.
InsulinInsulinomaThey sustained increased insulin levels even in a fasting state. Insulin-producing tumors are typically non-malignant.
Parathyroid hormone (PTH)Liver, renal, breast, lungEctopic PTH-producing adenomas are rare but produce PTH in excess, which leads to hypercalcemia.
ProlactinPituitary, renal, lungProlactinomas are common but benign pituitary tumors. Ectopic prolactin-producing carcinomas are sporadic.