Kobold Sebastian, Luetkens Tim, Cao Yanran, Bokemeyer Carsten, Atanackovic Djordje
Department of Oncology, Hematology, Stem Cell Transplantation with the section Pneumology, University Cancer Center Hamburg (Hubertus Wald Tumorzentrum), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Clin Dev Immunol. 2010;2010:721531. doi: 10.1155/2010/721531. Epub 2010 Dec 23.
There is an urgent need for earlier diagnosis of malignancies and more stringent monitoring of relapses after antitumor therapy. In addition, new prognostic markers are needed for risk stratification and design of individualized cancer therapies. New diagnostic and prognostic parameters should overcome the impairments of current standards in a cost-effective manner. Serological approaches measuring spontaneous antibody responses against tumor-associated antigens could be of use as diagnostic and prognostic markers and could also be employed to evaluate response to therapy in cancer patients. Autoantibodies have been suggested to be of frequent and specific occurrence in patients with malignancies and to correlate with clinical parameters. Screening the relevant literature on this topic, we suggest that the analysis of single antibody specificities is unlikely to provide sufficient diagnostic and prognostic accuracy. The combined analysis of autoantibodies targeting different antigens, however, may reach high sensitivity and specificity. In addition, screening cancer patients for autoantibodies might identify subgroups with high relapse risk and a worse prognosis. Larger prospective trials should be initiated to identify sets of tumor-associated autoantibodies suited for the use in diagnostic algorithms for cancer detection and followup.
迫切需要更早地诊断恶性肿瘤,并在抗肿瘤治疗后更严格地监测复发情况。此外,还需要新的预后标志物用于风险分层和个性化癌症治疗的设计。新的诊断和预后参数应以具有成本效益的方式克服当前标准的缺陷。检测针对肿瘤相关抗原的自发抗体反应的血清学方法可用作诊断和预后标志物,也可用于评估癌症患者的治疗反应。有人提出自身抗体在恶性肿瘤患者中经常出现且具有特异性,并与临床参数相关。通过筛选关于该主题的相关文献,我们认为对单一抗体特异性的分析不太可能提供足够的诊断和预后准确性。然而,对靶向不同抗原的自身抗体进行联合分析可能会达到高灵敏度和特异性。此外,对癌症患者进行自身抗体筛查可能会识别出复发风险高且预后较差的亚组。应启动更大规模的前瞻性试验,以确定适合用于癌症检测和随访诊断算法的肿瘤相关自身抗体组合。