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“)Caveat: When performing this procedure, possible effects on the upcoming tumor resection and subsequent reconstruction must be considered.
- Histologic (fine tissue)/immunohistologic examination and molecular genetics – this is the only way to distinguish Ewing’s sarcoma cells from other undifferentiated tumor cells of other tumor diseases
- Immunohistochemistry
- FISH (fluorescence in situ hybridization); when cytogenetic analysis is unsuccessful: Detection of translocations (chromosomal abnormality caused by rearrangement).
- PCR (polymerase chain reaction).
- 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(elevated in: peri- and postmenopausal osteoporosis (early detection possible with still normal bone densitometry); bone metastases; plasmocytoma (synonym: multiple myeloma); Paget’s disease; primary hyperparathyroidism (parathyroid hyperfunction).
- LDH (lactate dehydrogenase) [↑], ferritin* [↑], CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate) [↑] – especially in patients with large tumors.
- Wg. possible anemia: small blood count, ferritin* * , folic acid, vitamin B12, reticulocytes.
* Neoplasms, unspecified (due toFerritin is an acute-phase protein) [ferritin ↑; serum iron ↓↓; transferrin ↓]* * Low ferritin levels may be “masked” by inflammatory responses. Therefore, assessment of ferritin should be performed in parallel with C-reactive protein (acute-phase protein), if appropriate.
