Jacobs E L, Haskell C M
Department of Medicine, UCLA School of Medicine.
Curr Probl Cancer. 1991 Nov-Dec;15(6):299-360. doi: 10.1016/0147-0272(91)90005-u.
The perfect tumor marker would be one that was produced solely by a tumor and secreted in measurable amounts into body fluids, it should be present only in the presence of cancer, it should identify cancer before it has spread beyond a localized site (i.e., be useful in screening), its quantitative amount in bodily fluids should reflect the bulk of tumor, and the level of the marker should reflect responses to treatment and progressive disease. Unfortunately, no such marker currently exists, although a number of useful but imperfect markers are available. The predominant contemporary markers are discussed here by chemical class, as follows: glycoprotein markers, including carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-hCG), and prostate specific antigen (PSA); mucinous glycoproteins, including CA 15-3, CA 19-9, mucinous-like cancer antigen and associated antigens, and CA 125; enzymes, including prostatic acid phosphatase (PAP), neuron specific enolase (NSE), lactic acid dehydrogenase (LDH), and placental alkaline phosphatase (PLAP); hormones and related endocrine molecules, including calcitonin, thyroglobulin, and catecholamines; and, molecules of the immune system, including immunoglobulins and beta-2-microglobulin. The biologic properties of each group of tumor markers are discussed, along with our assessment of their role in clinical medicine today.
理想的肿瘤标志物应仅由肿瘤产生并以可测量的量分泌到体液中，仅在癌症存在时出现，在癌症扩散到局部部位之外之前就能识别癌症（即对筛查有用），其在体液中的定量应反映肿瘤的大小，并且标志物的水平应反映对治疗的反应和疾病进展。不幸的是，目前尚无这样的标志物，尽管有一些有用但并不完美的标志物。本文按化学类别讨论当代主要的标志物如下：糖蛋白标志物，包括癌胚抗原（CEA）、甲胎蛋白（AFP）、β-人绒毛膜促性腺激素（β-hCG）和前列腺特异性抗原（PSA）；粘液性糖蛋白，包括CA 15-3、CA 19-9、粘液样癌抗原及相关抗原，以及CA 125；酶，包括前列腺酸性磷酸酶（PAP）、神经元特异性烯醇化酶（NSE）、乳酸脱氢酶（LDH）和胎盘碱性磷酸酶（PLAP）；激素及相关内分泌分子，包括降钙素、甲状腺球蛋白和儿茶酚胺；以及免疫系统分子，包括免疫球蛋白和β2-微球蛋白。本文将讨论每组肿瘤标志物的生物学特性，以及我们对它们目前在临床医学中作用的评估。
