Tsao Kuo-Chien, Wu Tsu-Lan, Chang Pi-Yueh, Hong Ji-Hong, Wu James T
Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan.
J Clin Lab Anal. 2006;20(2):42-6. doi: 10.1002/jcla.20102.
A total of 73,443 asymptomatic individuals were screened on a voluntary basis for cancer at Chang Gung Memorial Hospital in Taiwan using a panel of tumor markers, including alpha fetoprotein (AFP), CA 125, CA 15-3, CA 19-9, carcinoembryonic antigen (CEA), prostate specific antigen (PSA), chromogranin A (CgA), and squamous cell specific antigen (SCC). The results are derived from data collected from January 1998 to October 2003. A total of 210 cancers (approximately 0.3%) were detected, including cancers of the liver, lung, colon, prostate, stomach, pancreas, breast, cervix, ovary, and bladder. Of the tumor markers monitored, elevated CA 19-9, CEA, and CA 125 were the most frequently detected in a variety of cancers. It was surprising to find that many cancers were not detected by their dominant markers but by the elevation of tumor markers not recommended for monitoring their tumor activity. Screening with multiple circulating tumor markers provides improved sensitivity for cancer detection in asymptomatic individuals before they reach the fatal advanced stage. Screening with multiple tumor markers also allows cancers to be detected in the absence of their dominant markers. If we had not measured the multiple tumor markers, these cancers would have gone undetected.
台湾长庚纪念医院共对73443名无症状个体进行了癌症自愿筛查，检测项目包括一组肿瘤标志物，即甲胎蛋白（AFP）、CA 125、CA 15 - 3、CA 19 - 9、癌胚抗原（CEA）、前列腺特异抗原（PSA）、嗜铬粒蛋白A（CgA）和鳞状细胞特异抗原（SCC）。结果源自1998年1月至2003年10月收集的数据。共检测出210例癌症（约0.3%），包括肝癌、肺癌、结肠癌、前列腺癌、胃癌、胰腺癌、乳腺癌、宫颈癌、卵巢癌和膀胱癌。在所监测的肿瘤标志物中，CA 19 - 9、CEA和CA 125升高在多种癌症中最为常见。令人惊讶的是，许多癌症并非通过其主要标志物检测到，而是通过不推荐用于监测肿瘤活性的肿瘤标志物升高检测到的。使用多种循环肿瘤标志物进行筛查可提高无症状个体在进入致命晚期之前癌症检测的敏感性。使用多种肿瘤标志物进行筛查还能在主要标志物缺失的情况下检测到癌症。如果我们没有检测多种肿瘤标志物，这些癌症就会漏检。
