Lange P H, Winfield H N
Cancer. 1987 Aug 1;60(3 Suppl):464-72. doi: 10.1002/1097-0142(19870801)60:3+<464::aid-cncr2820601506>3.0.co;2-c.
Tumor markers (TMs) play an important part in the management of urologic cancer. Alpha-fetoprotein, human chorionic gonadotropin, and occasionally lactic dehydrogenase serological determinations have become indispensable in the management of nonseminomatous germ cell testicular tumor patients, particularly after initial therapy, whereas human chorionic gonadotropin and probably placental alkaline phosphatase are important in seminoma. Prostatic acid phosphatase has long been important for the monitoring of patients with carcinoma of the prostate. The availability of the immunologic assays instead of the enzymatic assays has improved sensitivity somewhat but clinical interpretation has also become more complicated. Prostatic specific antigen is already an important tissue marker for carcinoma of the prostate and promises to be an important serological one, possibly surpassing prostatic acid phosphatase in importance. Analysis of DNA by automated flow cytometry is becoming important in the early detection and follow-up of bladder cancer patients. Studies concerning the tissue analysis of blood group antigens in bladder cancer continue to demonstrate that this approach can provide unique clinical information and interesting biological insights, but its role in routine clinical management remains to be determined. Currently, TMs have little clinical significance in renal cell carcinoma, but the availability of monoclonal antibodies to renal cell carcinoma preferential antigens may change this deficiency soon. In fact, in the near future, monoclonal antibodies will probably reveal many new substances for many urological cancers which can be used for markers serologically, histochemically, and, with their corresponding antibody, for radioimmune imaging and possibly immunotherapy. Now, as then, familiarity with the nuances of the marker and good clinical judgement will be essential.
肿瘤标志物（TMs）在泌尿生殖系统癌症的管理中发挥着重要作用。甲胎蛋白、人绒毛膜促性腺激素以及偶尔进行的乳酸脱氢酶血清学检测，在非精原细胞性生殖细胞睾丸肿瘤患者的管理中已变得不可或缺，尤其是在初始治疗后；而人绒毛膜促性腺激素以及可能的胎盘碱性磷酸酶在精原细胞瘤中很重要。前列腺酸性磷酸酶长期以来对于前列腺癌患者的监测很重要。免疫测定法取代酶测定法提高了一定的敏感性，但临床解读也变得更加复杂。前列腺特异性抗原已经是前列腺癌的重要组织标志物，并且有望成为重要的血清学标志物，其重要性可能超过前列腺酸性磷酸酶。通过自动流式细胞术分析DNA在膀胱癌患者的早期检测和随访中变得越来越重要。关于膀胱癌血型抗原组织分析的研究继续表明，这种方法可以提供独特的临床信息和有趣的生物学见解，但其在常规临床管理中的作用仍有待确定。目前，肿瘤标志物在肾细胞癌中临床意义不大，但针对肾细胞癌优先抗原的单克隆抗体的出现可能很快改变这一不足。事实上，在不久的将来，单克隆抗体可能会揭示许多用于多种泌尿生殖系统癌症的新物质，这些物质可用于血清学、组织化学标记，并且与相应抗体一起用于放射免疫成像以及可能的免疫治疗。现在，一如既往，熟悉标志物的细微差别和良好的临床判断力将至关重要。
