Translational Oncology Research Centre, Queen Alexandra Hospital, Southwick Hill, Portsmouth, PO6 3LY, UK.
BMC Cancer. 2011 Nov 30;11:499. doi: 10.1186/1471-2407-11-499.
Diagnosis of cancer at an early stage leads to improved survival. However, most current blood tests detect single biomarkers that are of limited suitability for screening, and existing screening programmes look only for cancers of one particular type. A new approach is needed. Recent developments suggest the possibility of blood-based screening for multiple tumour types. It may be feasible to develop a high-sensitivity general screen for cancer using multiple proteins and nucleic acids present in the blood of cancer patients, based on the biological characteristics of cancer. Positive samples in the general screen would be submitted automatically for secondary screening using tests to help define the likelihood of cancer and provide some indication of its type. Only those at high risk would be referred for further clinical assessment to permit early treatment and mitigate potential overdiagnosis. While the assays required for each step exist, they have not been used in this way. Recent experience of screening for breast, cervical and ovarian cancers suggest that there is likely to be widespread acceptance of such a strategy.
早期诊断癌症可提高生存率。然而，大多数当前的血液检测仅能检测到单一的生物标志物，这些标志物对于筛查的适用性有限，并且现有的筛查计划仅针对特定类型的癌症。需要采用新的方法。最近的研究进展表明，基于癌症的生物学特征，使用存在于癌症患者血液中的多种蛋白质和核酸，有可能实现针对多种肿瘤类型的血液筛查。利用针对癌症患者血液中存在的多种蛋白质和核酸的高灵敏度一般筛查，可能能够开发出用于癌症的一般筛查，基于癌症的生物学特征。如果一般筛查的阳性样本会自动提交进行二次筛查，以帮助确定癌症的可能性并提供其类型的一些指示，那么该方案有望得到广泛接受。只有那些高风险的患者才会被转介进行进一步的临床评估，以允许早期治疗并减轻潜在的过度诊断。虽然已经存在用于每个步骤的检测方法，但它们尚未以这种方式使用。筛查乳腺癌、宫颈癌和卵巢癌的最新经验表明，人们可能会广泛接受这种策略。
