Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Germany.
Arch Toxicol. 2011 Mar;85(3):185-92. doi: 10.1007/s00204-010-0580-2. Epub 2010 Aug 25.
The aim of the study is to examine the cancer-predictive values of SMRP (soluble mesothelin-related peptides), CA125, and CYFRA21-1 as potential tumor markers for lung cancer and malignant mesothelioma in a cohort of workers formerly exposed to asbestos. A voluntary surveillance program has been established for German workers with former asbestos exposure. A subgroup of 626 subjects with a mean age of 63 years (range 53-70 years) at baseline was enrolled in an extended health examination program with high-resolution computer tomography (HRCT) of the chest and blood drawing between 1993 and 1997. Serum concentrations of SMRP, CA125, and CYFRA21-1 were measured in archived serum samples in 2005 and 2006. A mortality follow-up was conducted through 2007. So far, 12 cases with lung cancer and 20 cases with malignant mesothelioma have been observed in this cohort. The average time between sample collection and diagnosis was 4.7 years. Analyzed biomarkers showed low sensitivities (5-25%) and positive predictive values (4-30%) for both cancer sites. Marker combinations resulted in sensitivities between 5 and 50% and positive predictive values ranging from 3 to 14%. Even in those cases, where biomarker concentrations were available within 36 months before diagnosis, no trend for increasing biomarker levels was observed. The analyzed tumor markers were characterized by high specificities, but low sensitivities. SMRP, CA125, and CYFRA21-1 alone or in combination were less suitable to serve as predictors for the diagnosis of lung cancer or malignant mesothelioma. However, a prospective study with annual sampling might reveal a better predictive value of these markers.
本研究旨在探讨 SMRP（可溶性间皮素相关肽）、CA125 和 CYFRA21-1 作为肺癌和恶性间皮瘤的潜在肿瘤标志物在曾接触石棉的工人队列中的癌症预测值。为曾接触过石棉的德国工人建立了一项自愿监测计划。1993 年至 1997 年期间，一项扩展健康检查计划招募了一组 626 名平均年龄为 63 岁（53-70 岁）的基线受试者，该计划包括胸部高分辨率计算机断层扫描（HRCT）和血液采集。在 2005 年和 2006 年，在存档的血清样本中测量了 SMRP、CA125 和 CYFRA21-1 的血清浓度。通过 2007 年进行了死亡率随访。到目前为止，在该队列中观察到 12 例肺癌和 20 例恶性间皮瘤。样本采集和诊断之间的平均时间为 4.7 年。分析的生物标志物对两个癌症部位的敏感性（5-25%）和阳性预测值（4-30%）均较低。标志物组合的敏感性在 5-50%之间，阳性预测值范围为 3-14%。即使在那些生物标志物浓度可在诊断前 36 个月内获得的病例中，也未观察到生物标志物水平升高的趋势。分析的肿瘤标志物具有较高的特异性，但敏感性较低。SMRP、CA125 和 CYFRA21-1 单独或组合使用不适合作为肺癌或恶性间皮瘤诊断的预测指标。然而，一项每年采样的前瞻性研究可能会揭示这些标志物更好的预测价值。
