Hulka B S, Wilcosky T
Department of Epidemiology, University of North Carolina, Chapel Hill.
Arch Environ Health. 1988 Mar-Apr;43(2):83-9. doi: 10.1080/00039896.1988.9935831.
This paper identifies some of the issues relevant to the use of biological markers in epidemiologic research. Foremost among these are clarity of definitions and marker classification. Illustrations of markers in the categories of internal dose, biological effective dose, biological response, disease, and susceptibility are presented with a theoretical model for the interrelationship among these. Issues faced by epidemiologists in selecting markers for specific studies concern exposure complexity, marker specificity, marker persistence, time to appearance, and the use of target vs. surrogate biological media. Feasibility issues concern sample collection, transport, storage, and characteristics of the laboratory assay. The rationale for biological markers in epidemiologic research is strong in that markers have the potential for (1.) improving the accuracy of our "exposure variables," (2.) permitting the identification of preclinical disease and providing opportunities for prevention, (3.) allowing for more homogeneous and etiologically relevant classifications of disease, and (4.) enhancing our understanding of the biological processes leading to disease occurrence, thereby strengthening the interpretation of epidemiologic data and the theoretical framework from which we formulate research questions.
本文确定了一些与在流行病学研究中使用生物标志物相关的问题。其中首要的是定义的清晰度和标志物分类。文中给出了内剂量、生物有效剂量、生物反应、疾病和易感性等类别中标志物的示例，并给出了这些标志物之间相互关系的理论模型。流行病学家在为特定研究选择标志物时面临的问题涉及暴露的复杂性、标志物的特异性、标志物的持久性、出现时间以及使用靶生物介质与替代生物介质。可行性问题涉及样本采集、运输、储存以及实验室检测的特性。流行病学研究中使用生物标志物的基本原理很充分，因为标志物有潜力：（1）提高我们“暴露变量”的准确性；（2）允许识别临床前疾病并提供预防机会；（3）实现对疾病更均匀且与病因相关的分类；（4）增强我们对导致疾病发生的生物学过程的理解，从而加强对流行病学数据的解释以及我们提出研究问题所依据的理论框架。
