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癌症的早期检测:血浆肿瘤标志物免疫测定法。

Early Detection of Cancer: Immunoassays for Plasma Tumor Markers.

作者信息

Meany Danni L, Sokoll Lori J, Chan Daniel W

机构信息

Center for Biomarker Discovery, Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA.

出版信息

Expert Opin Med Diagn. 2009 Nov 1;3(6):597-605. doi: 10.1517/17530050903266830.

Abstract

BACKGROUND

Plasma tumor biomarkers are widely used clinically for monitoring response to therapy and detecting cancer recurrence. However, only a limited number of them have been effectively used for the early detection of cancer. OBJECTIVE: To review plasma tumor markers used clinically for the early detection of cancer and to provide expert opinion about future directions. METHODS: Literature review, as well as our expert opinion, of plasma tumor markers that have been widely accepted for the early detection of cancer. RESULTS: In the United States, only prostate specific antigen (PSA), cancer antigen 125 (CA125), and alpha-fetoprotein (AFP) have been clinically used for the early detection of prostate, ovarian, and liver cancers, respectively. Both analytical and clinical issues related to the use of these three markers were discussed. CONCLUSION: Few plasma tumor markers have been used effectively for the early detection of cancer, mainly due to their limited sensitivity and/or specificity. Multiple approaches have been developed to improve the clinical performance of tumor markers for the early detection of cancer. Metrological traceability and antibody specificity are important issues to ensure comparability of immunoassays for the measurement of plasma tumor markers.

摘要

背景

血浆肿瘤生物标志物在临床上被广泛用于监测治疗反应和检测癌症复发。然而,其中只有少数被有效地用于癌症的早期检测。目的:综述临床上用于癌症早期检测的血浆肿瘤标志物,并就未来方向提供专家意见。方法:对已被广泛认可用于癌症早期检测的血浆肿瘤标志物进行文献综述以及我们的专家意见。结果:在美国,仅前列腺特异性抗原(PSA)、癌抗原125(CA125)和甲胎蛋白(AFP)分别在临床上用于前列腺癌、卵巢癌和肝癌的早期检测。讨论了与使用这三种标志物相关的分析和临床问题。结论:很少有血浆肿瘤标志物被有效地用于癌症的早期检测,主要是由于其敏感性和/或特异性有限。已经开发了多种方法来提高肿瘤标志物在癌症早期检测中的临床性能。计量溯源性和抗体特异性是确保用于测量血浆肿瘤标志物的免疫测定可比性的重要问题。

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本文引用的文献

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Nat Rev Urol. 2009 Jun;6(6):305-6. doi: 10.1038/nrurol.2009.93.
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N Engl J Med. 2009 Mar 26;360(13):1310-9. doi: 10.1056/NEJMoa0810696. Epub 2009 Mar 18.
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Screening for prostate cancer--the controversy that refuses to die.前列腺癌筛查——经久不息的争议。
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