Yilmaz Gülsen, Yilmaz Fatma Meriç, Senes Mehmet, Yucel Dogan
Clinical Biochemistry Laboratory, Ankara Hospital, Ministery of Health, 06340 Ankara, Turkey.
Indian J Clin Biochem. 2007 Mar;22(1):52-6. doi: 10.1007/BF02912881.
Serum tumor markers may be requested inappropriately by clinicians. In this retrospective study, we aimed to investigate the appropriateness of TM requests in our hospital. Patients in the study were identified from the TM requests for 3 months between June-August 2004, using the laboratory database. A total of 2249 patients (1351 men, 898 women) were included in the study and there were 6570 TM requests. The number of requests were 1050 (16%) for Carbohydrate Antigen 19-9, 993 (15.1%) for Cancer Antigen 125, 941 (14.3%) for Prostate Specific Antigen, 921 (14%) for free PSA, 925 (14.1%) for Cancer Antigen 15-3, 788 (12%) for Alphafetoprotein, 730 (11.1%) for Carcinoembryonic Antigen and 222 (3.4%) for AFP/Human Chorionic Gonadotrophin. Our findings support the idea that for the evidence-based use of TM requests the education of clinical staff is required. Clear clinical guidelines including recommendations about the appropriate use of TM can be useful for this education process. Careful audit studies are also useful to determine the impact of these guidelines on the practice of evidence-based laboratory medicine.
临床医生可能会不恰当地要求检测血清肿瘤标志物。在这项回顾性研究中,我们旨在调查我院肿瘤标志物检测申请的合理性。利用实验室数据库,从2004年6月至8月这3个月的肿瘤标志物检测申请中确定研究对象。共有2249例患者(1351例男性,898例女性)纳入研究,肿瘤标志物检测申请共6570项。其中,糖类抗原19-9检测申请1050项(16%),癌抗原125检测申请993项(15.1%),前列腺特异性抗原检测申请941项(14.3%),游离前列腺特异性抗原检测申请921项(14%),癌抗原15-3检测申请925项(14.1%),甲胎蛋白检测申请788项(12%),癌胚抗原检测申请730项(11.1%),甲胎蛋白/人绒毛膜促性腺激素检测申请222项(3.4%)。我们的研究结果支持这样一种观点,即要基于循证医学合理应用肿瘤标志物检测,就需要对临床工作人员进行培训。包括肿瘤标志物合理应用建议在内的明确临床指南,有助于开展此类培训。仔细的审核研究也有助于确定这些指南对循证检验医学实践的影响。