Moncada Victoria, Srivastava Sudhir
Cancer Biomarkers Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Biomark Med. 2008 Apr;2(2):181-95. doi: 10.2217/17520363.2.2.181.
Several important criteria are essential for the development of biomarkers in clinical oncology. First, the biomarkers should be easily measured using standardized and cost-efficient methods. Second, biomarkers should be easily attainable from clinical materials such as body fluids and cells. Third, biomarkers should have clearly defined cutoff values with high sensitivity and specificity. Lastly, the predictive value of biomarkers should be possible in strata as large as possible. Single biomarkers may not be able to meet all of these criteria, which necessitates the development of biomarker panels. High-throughput technologies will be necessary for measuring these biomarker sets and translation of these methods into a clinical setting will be necessary in order to employ these biomarkers in a healthcare setting. One of the most important aspects of biomarker development will be standardization and statistical evaluation of biomarker studies. Guidelines for biomarker studies need to be developed that will enable standardization to take place. The Early Detection Research Network has been in the forefront of this objective. Early detection of cancer through appropriately validated biomarkers will provide for decreased morbidity and mortality and allow for the development of new therapeutic tools targeted specifically toward eradication of these early malignancies, hopefully increasing the survival rate of patients diagnosed with early-stage cancer.
临床肿瘤学中生物标志物的开发需要几个重要标准。首先,生物标志物应能通过标准化且经济高效的方法轻松测量。其次,生物标志物应能从诸如体液和细胞等临床材料中轻松获取。第三,生物标志物应具有明确界定的临界值,且具有高敏感性和特异性。最后,生物标志物的预测价值应在尽可能大的分层中得以体现。单一生物标志物可能无法满足所有这些标准,这就需要开发生物标志物组合。测量这些生物标志物组合需要高通量技术,并且为了在医疗环境中应用这些生物标志物,有必要将这些方法转化到临床环境中。生物标志物开发最重要的方面之一将是生物标志物研究的标准化和统计评估。需要制定生物标志物研究指南,以实现标准化。早期检测研究网络一直处于这一目标的前沿。通过经过适当验证的生物标志物早期检测癌症将降低发病率和死亡率,并有助于开发专门针对根除这些早期恶性肿瘤的新治疗工具,有望提高早期癌症诊断患者的生存率。