TUMOUR MARKERS IN HEAD AND NECK CANCERS

• Markers are used for:

1. Diagnosis
2. Monitoring treatment and
3. Early diagnosis of recurrence

• These are found in blood, plasma and urine
• Cytological marker of oral cancer can be collected by mouth wash or cytological brushing but they are not diagnostic marker of invasive cancer.
• Rising and falling level of markers are usually associated with increase or decrease of tumour burden.
• The subject of tumour marker is in it’s infancy.
• Thyroid and Nasopharyngeal cancer are frequently used in clinical setting, mostly in the follow up.

IMPORTANT TUMOUR MARKERS:

      1. Nasopharyngeal Carcinoma (NPC):

• serum viral DNA of EBV by PCR
• used for prognosis and monitoring success of treatment.

      2. Squamous cell carcinoma antigen (SCCA):

• marker of head and neck SCC
• elevated level indicates recurrence and help in monitoring the treatment.

      3. SCCA for Inverted Papilloma: elevation indicates recurrence

      4. Ig against EA, VCA: elevated in NPC helps to diagnose and follow-up of treatment.

      5. Hormones used as a tumour marker:

• calcitonin: medullary carcinoma of thyroid
• catecholamines: pheochromacytoma
• thyroglobulin: thyroid cancer

      6. Enzymes:

• LDH: lymphoma
• Neuron specific enolase: Neuroblastoma and small cell carcinoma of lung.

     7. Immunohistochemistry:

• S-100: Schwannoma, meningioma, estheio-neuroblastoma
• Vimentin: melanoma, haemangiopericytoma
• Common leucocyte antigen:lymphoma
• Muscle specific actin and desmin: soft tissue tumour