Holdenrieder Stefan, Pagliaro Lance, Morgenstern David, Dayyani Farshid
University of Bonn, Bonn, Germany.
Mayo Clinic, Department of Oncology, Division of Medical Oncology, Rochester, MN, USA.
Biomed Res Int. 2016;2016:9795269. doi: 10.1155/2016/9795269. Epub 2016 Nov 30.
Before the introduction of modern imaging techniques and the recent developments in molecular diagnosis, tumor markers (TMs) were among the few available diagnostic tools for the management of cancer patients. Easily obtained from serum or plasma samples, TMs are minimally invasive and convenient, and the associated costs are low. Single TMs were traditionally used but these have come under scrutiny due to their low sensitivity and specificity when used, for example, in a screening setting. However, recent research has shown superior performance using a combination of multiple TMs as a panel for assessment, or as part of validated algorithms that also incorporate other clinical factors. In addition, newer TMs have been discovered that have an increased sensitivity and specificity profile for defined malignancies. The aim of this review is to provide a concise overview of the appropriate uses of both traditional and newer TMs and their roles in diagnosis, prognosis, and the monitoring of patients in current clinical practice. We also look at the future direction of TMs and their integration with other diagnostic modalities and other emerging serum based biomarkers, such as circulating nucleic acids, to ultimately advance diagnostic performance and improve patient management.
在现代成像技术引入以及分子诊断取得最新进展之前，肿瘤标志物（TMs）是用于癌症患者管理的少数可用诊断工具之一。TMs易于从血清或血浆样本中获取，具有微创、便捷的特点，且相关成本较低。传统上使用单一的TMs，但由于其在筛查等情况下使用时灵敏度和特异性较低，受到了审视。然而，最近的研究表明，将多个TMs组合作为一个评估面板，或作为包含其他临床因素的经过验证的算法的一部分，表现更优。此外，还发现了对特定恶性肿瘤具有更高灵敏度和特异性的新型TMs。本综述的目的是简要概述传统和新型TMs的适当用途及其在当前临床实践中在诊断、预后和患者监测中的作用。我们还探讨了TMs的未来方向及其与其他诊断方式以及其他新兴的基于血清的生物标志物（如循环核酸）的整合，以最终提高诊断性能并改善患者管理。
