Chatterjee Madhumita, Levin Nancy K, Shah Jay P, Ionan Alexei, Grates Harry E, Tainsky Michael A
Karmanos Cancer Institute/Wayne State University School of Medicine, Program in Molecular Biology and Genetics, Department of Pathology, 110 E. Warren, Detroit, MI 48201, USA.
Expert Opin Med Diagn. 2007 Sep;1(1):3-15. doi: 10.1517/17530059.1.1.3.
Proteomic and genomic technologies have been developed that can simultaneously detect large panels of cancer biomarkers in body fluids such as serum, plasma, sputum, saliva or urine. These approaches provide great promise for the early detection of cancer, but have thrust the field into the era of diagnostic multianalyte-based cancer tests with few, if any, models for the implementation of such tests. These multianalyte tests may be based on the detection of serum antibodies to tumor antigens, the presence of cancer-related proteins in serum or the presence of tumor-specific genomic changes that appear in plasma as free DNA. The application of noninvasive diagnostic approaches to detect early stage cancer will provide the physician with greater presymptomatic periods for clinical intervention, but it is uncertain how the various forces will impact their implementation in a patient care setting. Utilization will be balanced by medical follow-up pathways, commercial/reimbursement factors and regulatory issues that influence implementation of new devices in the marketplace.
蛋白质组学和基因组技术已经得到发展，这些技术能够同时检测血清、血浆、痰液、唾液或尿液等体液中的大量癌症生物标志物。这些方法为癌症的早期检测带来了巨大希望，但也将该领域推进到了基于多分析物的癌症诊断测试时代，而实施此类测试的模型却寥寥无几。这些多分析物测试可能基于对肿瘤抗原血清抗体的检测、血清中癌症相关蛋白质的存在或血浆中作为游离DNA出现的肿瘤特异性基因组变化的检测。应用非侵入性诊断方法检测早期癌症将为医生提供更长的临床干预症状前期，但尚不确定各种因素将如何影响其在患者护理环境中的实施。新设备在市场上的应用将受到医学随访途径、商业/报销因素和监管问题的制约。
