Beastall G H, Cook B, Rustin G J, Jennings J
Institute of Biochemistry, Royal Infirmary, Glasgow, Scotland.
Ann Clin Biochem. 1991 Jan;28 ( Pt 1):5-18. doi: 10.1177/000456329102800102.
Increasing numbers of commercial assays for the established tumour markers are available which are capable of excellent analytical performance. Whilst all these assays are useful as research tools, their clinical value is more limited and should be appreciated before any decision is taken to offer a tumour marker assay service. 1. Calcitonin (medullary carcinoma of thyroid), alphafetoprotein (hepatoma) and human chorionic gonadotrophin (choriocarcinoma) are the only tumour markers that can be used for screening for malignancy in high risk populations. 2. Hormones, paraproteins, alphafetoprotein, human chorionic gonadotrophin and prostate specific antigen are valuable in establishing the diagnosis of certain tumour types. 3. Alphafetoprotein and human chorionic gonadotrophin concentrations at the time of diagnosis are of value in predicting prognosis in specific tumour types. 4. Although their sensitivity for a particular tumour type may be poor, most tumour markers can be used for monitoring the therapy and follow-up of selected marker positive patients. Optimal clinical results of the management of patients with malignancy are usually obtained by specialist centres, and laboratory tumour marker services should be established so that they are appropriate to local oncology specialities.
针对已有的肿瘤标志物，越来越多的商业检测方法可供使用，这些方法具有出色的分析性能。虽然所有这些检测方法作为研究工具都很有用，但它们的临床价值更为有限，在决定提供肿瘤标志物检测服务之前应予以重视。1. 降钙素（甲状腺髓样癌）、甲胎蛋白（肝癌）和人绒毛膜促性腺激素（绒毛膜癌）是仅有的可用于在高危人群中筛查恶性肿瘤的肿瘤标志物。2. 激素、副蛋白、甲胎蛋白、人绒毛膜促性腺激素和前列腺特异性抗原在确定某些肿瘤类型的诊断方面很有价值。3. 诊断时甲胎蛋白和人绒毛膜促性腺激素的浓度在预测特定肿瘤类型的预后方面具有价值。4. 尽管大多数肿瘤标志物对特定肿瘤类型的敏感性可能较差，但它们可用于监测选定的标志物阳性患者的治疗和随访。恶性肿瘤患者管理的最佳临床结果通常由专科中心获得，并且应建立实验室肿瘤标志物服务，使其适合当地肿瘤学专业。
