Iwasaki Yoshiaki, Arai Kuniyoshi, Katayanagi Soh, Takahashi Keiichi, Yamaguchi Tatsurou, Matsumoto Hiroshi, Miyamoto Hidenori
Department of Surgery, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
Gan To Kagaku Ryoho. 2004 Jul;31(7):1015-20.
This review is concerned with the usefulness and the problem of biomarkers for cancer of digestive organs. Carcinoembryonic antigen (CEA) is a most popular and useful tumor marker for cancer of digestive organs. Squamous cell carcinoma (SCC) antigen and CYFRA have been reported as a useful tumor marker for esophageal cancer. CEA and CA 19-9 are a good prognostic factor in gastric cancer patients. The post-operative increase of serum CEA can be a predictive marker for the patients of colorectal cancer. Development of a radioimmunoassay for highly sensitive detection of tumor markers, they are considered to be useful for monitoring after treatment. But are not useful for the early diagnosis. The diagnosis of hepatocellular carcinoma (HCC) is based mainly on serological markers, such as alpha-fetoprotein and PIVKA-II. The two are useful complementary markers of HCC because they do not correlate with each other. But the problem of the false-positive rate for the patients with chronic hepatitis or liver cirrhosis is still remained. A typical marker of pancreatic and bile duct cancer is carbohydrate antigen, but the sensitivity of these markers is only 50%. Recent molecular biological analysis may be used as effective biomarkers in the diagnosis, prognosis, therapy, and risk assessment of digestive cancer.
本综述关注消化系统器官癌症生物标志物的实用性和问题。癌胚抗原(CEA)是消化系统器官癌症最常用且有用的肿瘤标志物。鳞状细胞癌(SCC)抗原和细胞角蛋白片段(CYFRA)已被报道为食管癌的有用肿瘤标志物。CEA和CA 19 - 9是胃癌患者良好的预后因素。血清CEA术后升高可作为结直肠癌患者的预测标志物。开发用于高灵敏度检测肿瘤标志物的放射免疫测定法,它们被认为对治疗后监测有用。但对早期诊断无用。肝细胞癌(HCC)的诊断主要基于血清学标志物,如甲胎蛋白和异常凝血酶原(PIVKA - II)。两者是HCC有用的互补标志物,因为它们相互之间不相关。但慢性肝炎或肝硬化患者假阳性率的问题仍然存在。胰腺癌和胆管癌的典型标志物是糖类抗原,但这些标志物的敏感性仅为50%。最近的分子生物学分析可能用作消化系统癌症诊断、预后、治疗和风险评估中的有效生物标志物。