1st order laboratory parameters – obligatory laboratory tests.
- Biopsy (tissue sample) – to determine the type of tumor as well as its aggressiveness; most important diagnostic measure in cases of suspected tumor; performed following imaging procedures (see “Medical Device Diagnostics“).
- Alkaline phosphatase (AP) isoenzymes, ostase, urinary calcium (tumor hypercalcemia (synonym: tumor-induced hypercalcemia, TIH) is one of the most common symptoms in paraneoplastic syndromes), PTHrP (parathyroid hormone-related protein; the constellation with decreased parathyroid hormone (PTH) and increased PTHrP is typical for tumor hypercalcemia) – if bone metastases are suspected.
- Deoxypyridinoline (DPD) – is > 98% bone specific – a good index of bone resorption rate(increased in: peri- and postmenopausal osteoporosis (early detection possible if bone densitometry is still normal); bone metastases.
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Wg. possible anemia (anemia): small blood count, ferritin * , folic acid, vitamin B12, reticulocytes.
* Low ferritin levels may be “masked” by inflammatory responses. Therefore, the assessment of ferritin should be performed in parallel with C-reactive protein (acute phase protein), if necessary.