[Tumor markers]

Several substances, referred to as tumor markers, are associated with neoplasms development. The specificity of these cancer related substances or antigens depends on their nature (onco-fetal antigens, placental antigens) or on their concentration and physico-chemical forms (hormones, exocrine products, enzymes,...). On the basis of physico-chemical, immunochemical and biochemical analogies which exist between these tumor markers and substances normally found at particular times of life, a classification of these markers may be proposed. Tumor markers are almost constantly found within carcinoma cells by immunocytochemical techniques and are secreted by carcinoma explants in culture medium. On the hand, the release of tumor markers in biological fluids (blood, cerebrospinal fluid, urines,...) is less frequently detected by sensitive methods such as radioimmunoassay. Several factors are responsible for this discrepancy between the intra-tumoral presence of tumor markers and the lower incidence of their detection in biological fluids. These factors are discussed. These tumor markers have attracted considerable attention from pathologists and clinicians. Thus, detection of these substances, especially by immunocytochemical methods, may be related to a situation of neoplastic transformation and allow a functional classification superimposed to histological classification superimposed to histological classification of tumors. Moreover, ectopic production of hormones and/or neuromediators explains some clinical symptoms in cancer processes. Furthermore, products of normal cell activity at the origin of cancer (hormones, enzymes, exocrine products) when evidenced within the neoplastic cells or within serum might constitute a hormonal dependence index useful for therapeutical orientation. Finally, tumor marker levels are related to the local and systemic extension of the neoplasia and may be considered as valid index of prognosis. The determination of the levels of these tumor markers provides a quantitative criterion of the evolution of the neoplastic disorder and for following the efficacy or inefficacy of treatment.