Other cancers

♦ Serum AFP is elevated at presentation in 50-80% of UK patients with hepatocellular carcinoma and may be used in screening of high-risk populations.

♦ Neuron-specific enolase (NSE) is elevated in many patients with advanced small-cell lung cancers and in children with neuroblas-toma.

♦ Paraprotein levels are very important in the management of patients with myeloma, where B2-micro-globulin may be of prognostic value.

♦ Carcinoid tumours can be monitored by urine levels of 5-hydroxy-indole acetic acid (5HIAA), and polypeptides such as gastrin or glucagon are useful in the management of rare gastrointestinal tumours.

♦ Squamous cell carcinomas are associated with elevated levels of squamous cell carcinoma antigen (SCC) as well as cytokeratin fragments. SCC and CA 125 give valuable prognostic information in patients with cervical carcinoma and may indicate relapse before scans.

♦ Calcitonin and calcitonin-related peptide are used in diagnosis and screening for medullary thyroid carcinoma.

♦ Serum S-100 and reverse transcriptase polymerase chain reaction to detect mRNA of tyrosinase on circulating melanoma cells are being studied for staging and follow-up of patients with melanoma.

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