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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Whitfield, John B.

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Increased plasma concentrations of tumour markers in the absence of neoplasia

1 / Xavier Filella2 / Montse Alsina-Donadeu3 / Lluïsa Juan-Pereira4 / Àngels Bosch-Ferrer5 / Raül Rigo-Bonnin6 /

1Laboratory Medicine, Biological Diagnosis Department, Manresa Althaia Xarxa Assistencial de Manresa, Manresa, Catalonia, Spain

2Biochemistry and Molecular Genetics Service (CDB), Hospital Clínic, Barcelona, Catalonia, Spain

3Clinical Analysis Laboratory, CATLAB Viladecavalls, Villadecavalls, Catalonia, Spain

4Clinical Analysis Service, Sant Joan de Deu Hospital, Martorell, Catalonia, Spain

5Consorci Laboratori Intercomarcal, Igualada, Catalonia, Spain

6Clinical Laboratory, Bellvitge University Hospital, L’Hospitalet de Llobregat, Catalonia, Spain

Corresponding author: Jaume Trapé, Servei de Bioquímica, Departament de Diagnòstic Biològic, Althaia Xarxa Assistencial de Manresa, C/Dr Joan Soler 1-3, 08243 Manresa, Catalonia, Spain

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 49, Issue 10, Pages 1605–1620, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2011.694, September 2011

Publication History

Received:
2011-03-28
Accepted:
2011-07-25
Published Online:
2011-09-06

Abstract

Tumour markers are a very heterogeneous group of molecules that are generally found in very small concentrations in the plasma and serum of healthy individuals. In the process of neoplastic differentiation the cell can synthesize, release, or induce synthesis of other cells, thus increasing their concentration in plasma and serum. These substances may also increase their plasma concentration in patients without cancer due to processes that increase the release or reduce catabolism, and so give rise to false positives. An understanding of the main physiopathological processes that increase the concentrations of these substances could improve our interpretation of tumour markers and their clinical application. In this study we review the physiopathological processes that may increase the plasma concentrations of tumour markers. We performed a bibliography review in PubMed, searching for causes of false positives for the following tumour markers: α-Fetoprotein, CA 125, CA 15-3, CA 19-9, CA 72-4, carcinoembryonic antigen, CYFRA 21-1, squamous cell carcinoma, prostatic specific antigen, β2-microglobulin, choriogonadotropin (β chain), chromogranin A, neuron specific enolase, HER2-neu, progastrin releas-ing peptide, S-100, and thyroglobulin. The results favour the use of tests which can identify pathological processes that may increase tumour marker concentrations.

Keywords: benign disease; false positives; tumour markers

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