Division of Oncological Diagnostics
Head of the Division : Péter Antal-Szalmás, MD, PhD, Béla Nagy, MD, PhD
Chief Technologist: Sára Sarudi
The Oncological Diagnostic Division started its work on the 1st of January 2001. The diagnostic repertoire of the division can be divided into three major areas:
1., measurement of serum tumor markers by immunoassays,
2., diagnostic tests in oncology based on molecular biological methods,
3., determination of bone-turnover markers using immunoassays and molecular biological methods.
Serum tumor marker determinations
The majority of these tests (11 analytes: PSA, free PSA, CEA, AFP, HCG-β, CA125, CA15-3, CA19-9, CA72-4, Cyfra 21-1, NSE) are measured by a Roche MODULAR E170 analyzer. Two markers (Thyreoglobulin and TPA) are performed by the Immunochemistry Division, while Calcitonin is measured by the Endocrinology Division of the Department. The interest in the serum tumor marker determination is increasing constantly since the foundation of the division. The number of tests was 8,500 in 2000 while 61,000 in 2009. Due to the increasing number of tests we changed the frequency of measurement and provide results each day of a week.
The diagnostic tests using molecular biological methods can be grouped into two major profiles. The first group of assays - together with the flow cytometric determinations - serves the diagnostics and follow-up of the hematological malignancies and the identification of minimal residual disease (Immunoglobulin heavy chain (IgH) and T cell receptor gamma gene rearrangements, analysis of mutations of the FLT3 and JAK2 genes). The second group of tests supports the diagnostics of solid tumors and helps the identification of tumor susceptibility (mutations in the Ret oncogene in the case of medullary thyroid carcinoma or in the BRCA1,2 genes in hereditary breast cancer). More recently, we perform RNA-based tests, too. The identification of bcr/abl-t(9;22) translocation using a nested PCR or a real-time quantitative PCR serves the diagnostics of CGL/ALL. The most important molecular biological methods used in these assays are: PCR, nested PCR, PCR+RFLP, detection of PCR products by PAGE, agarose gel electrophoresis and fragment analysis, verification of the results by sequencing and by real-time quantitative PCR. Test results are available once per 2-3 weeks.
Markers of bone metabolism
Three serum markers of bone metabolism are measured by a Roche MODULAR E170 analyzer. "Osteocalcin" and "Procollagen N-terminal propeptide (P1NP)" are specific for bone-formation, while "Crosslinked collagen C-telopeptide (Crosslaps, β-CTx)" is characteristic for bone resorption. In January 2005, we introduced a new test - determination of the G1245T polymorphism in the COL1A1 gene - which is a useful marker in the prediction of osteoporosis associated fractures, furthermore, it can predict the efficacy of bisphosphonate therapy. Serum bone marker test results are available once (Friday) per week, while results of the genotyping are given once per 3 weeks. The results of each test of the division are presented to the physicians of the Medical Center online via the MedSolution system and for doctors outside of the University via regular post.