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Different types of laboratory tests:
Clinical chemistry uses chemical processes to measure levels of chemical components in body fluids and tissues. The most common specimens used in clinical chemistry are blood and urine. Many different tests exist to detect and measure almost any type of chemical component in blood or urine.
The laboratory at OnCare would provide some of the more common laboratory tests:
1. Blood Tests
Blood tests are used to measure the number of blood cells in circulation and the levels of chemicals, enzymes, proteins, and organic waste products that are normally found in the blood.
The levels of blood cells, such as red blood cells, white blood cells and platelets, may be low in patients receiving treatment for cancer. Also, the levels of some chemicals normally found in the blood may be either too high or too low as a result of the cancer or its treatment.
There are two types of blood tests typically performed during cancer treatment: the complete blood count (CBC) and a blood chemistry panel.
2. Urinalysis
Urinalysis breaks down the components of urine to check for the presence of drugs, blood, protein, and other substances.
Blood in the urine (hematuria) may be the result of a benign (noncancerous) condition, but it can also indicate an infection or other problem. High levels of protein in the urine (proteinuria) may indicate a kidney or cardiovascular problem.
3. Tumor Markers
Tumor markers are substances either released by cancer cells into the blood or urine or substances created by the body in response to cancer cells.
Tumor markers are used to evaluate how well a patient has responded to treatment and to check for tumor recurrence. Research is currently being conducted on the role of tumor markers in detection, diagnosis, and treatment of cancers.
Some tumor markers that are currently in common use are listed below:
ALK gene rearrangements
- Cancer types: Non-small cell lung cancer and anaplastic large cell lymphoma
- Tissue analyzed: Tumor
- How used: To help determine treatment and prognosis
Alpha-fetoprotein (AFP)
- Cancer types: Liver cancer and germ cell tumors
- Tissue analyzed: Blood
- How used: To help diagnose liver cancer and follow response to treatment; to assess stage, prognosis, and response to treatment of germ cell tumors
Beta-2-microglobulin (B2M)
- Cancer types: Multiple myeloma, chronic lymphocytic leukemia, and some lymphomas
- Tissue analyzed: Blood, urine, or cerebrospinal fluid
- How used: To determine prognosis and follow response to treatment
Beta-human chorionic gonadotropin (Beta-hCG)
- Cancer types: Choriocarcinoma and testicular cancer
- Tissue analyzed: Urine or blood
- How used: To assess stage, prognosis, and response to treatment
BCR-ABL fusion gene
- Cancer type: Chronic myeloid leukemia
- Tissue analyzed: Blood and/or bone marrow
- How used: To confirm diagnosis and monitor disease status
CA15-3/CA27.29
- Cancer type: Breast cancer
- Tissue analyzed: Blood
- How used: To assess whether treatment is working or disease has recurred
CA19-9
- Cancer types: Pancreatic cancer, gallbladder cancer, bile duct cancer, and gastric cancer
- Tissue analyzed: Blood
- How used: To assess whether treatment is working
CA-125
- Cancer type: Ovarian cancer
- Tissue analyzed: Blood
- How used: To help in diagnosis, assessment of response to treatment, and evaluation of recurrence
Calcitonin
- Cancer type: Medullary thyroid cancer
- Tissue analyzed: Blood
- How used: To aid in diagnosis, check whether treatment is working, and assess recurrence
Carcinoembryonic antigen (CEA)
- Cancer types: Gastrointestinal, lung, pancreatic and breast cancers
- Tissue analyzed: Blood
- How used: To check whether colorectal cancer has spread; to look for breast cancer recurrence and assess response to treatment
CD20
- Cancer type: Non-Hodgkin lymphoma
- Tissue analyzed: Blood
- How used: To determine whether treatment with a targeted therapy is appropriate
Chromogranin A (CgA)
- Cancer type: Neuroendocrine tumors
- Tissue analyzed: Blood
- How used: To help in diagnosis, assessment of treatment response, and evaluation of recurrence
Chromosomes 3, 7, 17, and 9p21
- Cancer type: Bladder cancer
- Tissue analyzed: Urine
- How used: To help in monitoring for tumor recurrence
EGFR mutation analysis
- Cancer type: Non-small cell lung cancer
- Tissue analyzed: Tumor
- How used: To help determine treatment and prognosis
Estrogen receptor (ER) / progesterone receptor (PR)
- Cancer type: Breast cancer
- Tissue analyzed: Tumor
- How used: To determine whether treatment with hormonal therapy (such as Tamoxifen) is appropriate
Fibrin/fibrinogen
- Cancer type: Bladder cancer
- Tissue analyzed: Urine
- How used: To monitor progression and response to treatment
HE4
- Cancer type: Ovarian cancer
- Tissue analyzed: Blood
- How used: To assess disease progression and monitor for recurrence
HER2/neu
- Cancer types: Breast cancer, gastric cancer, and esophageal cancer
- Tissue analyzed: Tumor
- How used: To determine whether treatment with Trastuzumab is appropriate
Immunoglobulins
- Cancer types: Multiple myeloma and Waldenström macroglobulinemia
- Tissue analyzed: Blood and urine
- How used: To help diagnose disease, assess response to treatment, and look for recurrence
KIT
- Cancer types: Gastrointestinal stromal tumor and mucosal melanoma
- Tissue analyzed: Tumor
- How used: To help in diagnosing and determining treatment
KRAS mutation analysis
- Cancer types: Colorectal cancer and non-small cell lung cancer
- Tissue analyzed: Tumor
- How used: To determine whether treatment with a particular type of targeted therapy is appropriate
Lactate dehydrogenase
- Cancer type: Germ cell tumors
- Tissue analyzed: Blood
- How used: To assess stage, prognosis, and response to treatment
Nuclear matrix protein 22
- Cancer type: Bladder cancer
- Tissue analyzed: Urine
- How used: To monitor response to treatment
Prostate-specific antigen (PSA)
- Cancer type: Prostate cancer
- Tissue analyzed: Blood
- How used: To help in diagnosis, assess response to treatment, and look for recurrence
Thyroglobulin
- Cancer type: Thyroid cancer
- Tissue analyzed: Tumor
- How used: To evaluate response to treatment and look for recurrence
21-Gene signature (Oncotype DX)
- Cancer type: Breast cancer
- Tissue analyzed: Tumor
- How used: To evaluate risk of recurrence
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