Description

Biochemistry Department

At the Biochemistry Department of Anadolu Medical Center,
we offer services in the area of biochemistry, toxicology, hematology,
coagulation, immunology, endocrinology, serology with our experienced staff
including 3 medical doctors and 18 laboratory technicians as well as in the
areas of molecular cytogenetics with private chemistry and business
partnerships.

The most important priority of our laboratory is quality,
and we follow the standards of the “Clinical Laboratory Standards Institute”;
accuracy and reproducibility of the test results are checked via the internal
quality control program, whereas international compliance of the results are
checked via various national and international external quality control
programs including, in particular, College of American Pathologists.

In our laboratory, in addition to routine tests performed
in the diagnosis and treatment processes of various cancers, we perform special
studies such as tumor markers for certain types of cancer, hereditary cancer
genetic screening tests, and antibody response assays in immunotherapy with
racotumomab.

1- Tumor Markers

Tumor markers are enzymes, proteins, antigens or hormones
found in blood that used to screen, diagnose, classify, monitor the progress of
cancer and to evaluate success of the treatment or to detect relapse.

Primary tumor markers are as follows:

PSA (Prostate-specific Antigen): It is used in the
screening, diagnosis, staging of prostate cancer as well as in the monitoring
of treatment.

CEA (Carcinoembryonic Antigen): It is used in the
diagnosis and staging of gastric, intestinal and pancreatic cancers as well as
in the monitoring of the treatment.

CA 15-3: It is used in the monitoring of the treatment in
patients with metastatic breast cancer.

CA 125 and HE4 (Human Epididymis Protein): These are
tumor markers related to ovarian and cervical cancers.

CA 19-9: These are tumor markers related to pancreatic
and intestinal cancers.

CA 72-4: These are tumor markers related to gastric and
intestinal cancers.

HCG (Chorionic Gonadotropin): It is used in the diagnosis
and treatment of trophoblastic tumors and testicular tumors.

AFP (Alpha-fetoprotein): It is used in the diagnosis and
treatment of liver cancer and testicular tumors.

Calcitonin: It is used in the diagnosis of medullary
thyroid cancer.

NMP-22 (Nuclear Matrix protein): It is used in the
diagnosis of bladder cancer.

As described above, the only tumor marker to be used in
cancer screening today is PSA. Other tumor markers are rather used to give
clues about the diagnosis and monitoring of the disease, evaluation of the
success of treatment and detection of relapse if any, and help the doctor in
his/her decision-making process.

The most important issue to keep in mind in relation to
tumor markers is that some of them may be elevated due to reasons other than
cancer, in other words, most of them are not specific to cancer. Therefore,
patients should not panic against results outside the specified normal range,
particularly when results are slightly beyond the normal range. This elevation
may completely result from a healthy situation. Doctors always evaluate tumor
marker results not in their own right, but as a whole along with their own
examination findings and other examinations such as imaging.

Another point to consider in relation to tumor markers is
that these tests will be required at certain intervals in order to monitor the
disease. In order for the new results to be comparable to the results of
previous tests and for the doctors to evaluate increases and decreases
confidently, these tests should, to the extent possible, be performed at the
same laboratory.

2- Hereditary Cancer Genetic Screening

It is recognized that cancer has a genetic origin, i.e.
it results from some changes in the genes. These genetic changes are most of
the time acquired, i.e. some changes occur in the genetic structure of a person
throughout his/her life. Only a small part of these are hereditary. In other
words, a person takes genes from his/her family which make him/her more
sensitive against cancer. As a result, whether acquired or hereditary, these
changes in the genetic structure of a person disrupt the relevant mechanisms
with proliferation, differentiation of cells and cell death, and cancer occurs
with uncontrolled proliferation of cells.

It is argued that hereditary cancer syndromes constitute
5 to 10 percent of diagnosed cancer cases. These syndromes stem from mutations
in certain genes, and may cause development of cancer in certain organs like
the breast, colon, thyroid gland, skin and kidney.

With the Hereditary Cancer Genetic Screening Program,
APC, ATM, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4, CDKN2A, CHEK2, EPCAM, MEN1,
MET, MLH1, MSH2, MSH6, MUTYH, NBN, PAL genes are screened in blood and it is
detected whether the person carries mutations which may be related to cancer or
not. Again with the BRCA1 and BRCA2 Mutation Analysis test studied in blood,
patients who specifically have breast and ovarian cancer in their families are
evaluated for risk.

3- Antibody Assay for Monitoring Immunotherapy

Immunotherapy is one of the recent developments in cancer
treatment. Racotumomab is one of these therapies which has different types and
essentially aims to use the person’s own immune system for therapeutic
purposes. Racotumomab is an antibody vaccine which has been developed to react
to N-Glycol GM3 Ganglioside (NGcGM3), an antigen found in the surface of the
lung cancer cell. Racotumomab IgM and Racotumomab IgG tests are used at our
laboratory to evaluate therapeutic success in patients to whom this vaccine has
been administered.