Burke Harry B
Professor of Medicine, Department of Medicine, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Biomark Cancer. 2016 Jun 6;8:89-99. doi: 10.4137/BIC.S33380. eCollection 2016.
Over the past 20 years, there has been an exponential increase in the number of biomarkers. At the last count, there were 768,259 papers indexed in PubMed.gov directly related to biomarkers. Although many of these papers claim to report clinically useful molecular biomarkers, embarrassingly few are currently in clinical use. It is suggested that a failure to properly understand, clinically assess, and utilize molecular biomarkers has prevented their widespread adoption in treatment, in comparative benefit analyses, and their integration into individualized patient outcome predictions for clinical decision-making and therapy. A straightforward, general approach to understanding how to predict clinical outcomes using risk, diagnostic, and prognostic molecular biomarkers is presented. In the future, molecular biomarkers will drive advances in risk, diagnosis, and prognosis, they will be the targets of powerful molecular therapies, and they will individualize and optimize therapy. Furthermore, clinical predictions based on molecular biomarkers will be displayed on the clinician's screen during the physician-patient interaction, they will be an integral part of physician-patient-shared decision-making, and they will improve clinical care and patient outcomes.
在过去20年里，生物标志物的数量呈指数级增长。据最新统计，在PubMed.gov上索引的直接与生物标志物相关的论文有768,259篇。尽管其中许多论文声称报告了临床上有用的分子生物标志物，但令人尴尬的是，目前临床应用的却很少。有人认为，未能正确理解、临床评估和利用分子生物标志物阻碍了它们在治疗、比较效益分析以及将其纳入个性化患者预后预测以用于临床决策和治疗中的广泛应用。本文提出了一种直接、通用的方法，用于理解如何使用风险、诊断和预后分子生物标志物来预测临床结果。未来，分子生物标志物将推动风险、诊断和预后方面的进展，它们将成为强大分子疗法的靶点，并且将使治疗个性化并实现优化。此外，基于分子生物标志物的临床预测将在医患互动期间显示在临床医生的屏幕上，它们将成为医患共同决策的一个组成部分，并且将改善临床护理和患者预后。
