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[免疫肿瘤诊断]

[The immunologic tumor diagnosis].

作者信息

Müller M

出版信息

Z Gesamte Inn Med. 1976 Oct 1;31(19):782-90.

PMID:65843
Abstract

Issuing from a possibility of classification of tumour-associated antigens (TAA), corresponding to themodern state of recognition, the present situation of the immunological tumour diagnostics is discussed. The direct proof of tumour-associated antigens in the blood or in other body fluids, as one of the fundamental possibilities, is hitherto practically matured only for the alpha-fetoprotein and in this case only contribute to the diagnostics of liver carcinomas and malignant teratoblastomas. The determination of the carcinoembryonal antigen (CEA) in the serum or plasm has at present no essential diagnostic significance, may however, be used for the control of the therapeutic effect of cancer of the colon, rectum as well as the stomach. It is reserved for prospective studies to estimate the valency of the determination of CEA or fetal sulphoglycoproteid antigen in the gastric juice for the recognition of early carcinomas of the stomach. At present the proof of an immune response of the tumor carrier to TAA in vitro seems to be more favourable as a second way of the immunological tumour diagnostics. Sensitivity as well as specificity might here at first higher be estimated, when they are theoretically established. Whereas the inhibition test of leucocyte migration and technically similar variants in apparently sufficient specifity have an insufficient sensitivity and thus give too many falsely negative results the mobility test of the electrophoresis of macrophages in the modification of the immunological tumour profile distinguishes itself by a high certainty and by evidence on the probable localisation of the organ and the primary tumour (up to now verified for the cancer of colon and rectum, carcinomas of the stomach). Apart from the research of further principles, however, even for this test technological simplifications are to be found, before a broader use in routine work becomes practicable.

摘要

基于肿瘤相关抗原(TAA)分类的可能性以及当前的识别现状,本文讨论了免疫肿瘤诊断的现状。作为基本可能性之一,在血液或其他体液中直接检测肿瘤相关抗原,目前实际上仅对甲胎蛋白而言已基本成熟,且仅有助于肝癌和恶性畸胎瘤的诊断。目前,血清或血浆中癌胚抗原(CEA)的测定没有本质的诊断意义,但可用于监测结肠癌、直肠癌以及胃癌的治疗效果。对于胃液中CEA或胎儿硫糖蛋白抗原的测定在早期胃癌识别中的价值评估,有待前瞻性研究。目前,作为免疫肿瘤诊断的第二种方法,肿瘤携带者对TAA的体外免疫反应检测似乎更具优势。理论上确定时,其敏感性和特异性起初可能更高。白细胞迁移抑制试验及技术上类似的变体,特异性明显足够,但敏感性不足,因此会产生过多假阴性结果;而免疫肿瘤图谱改良版中巨噬细胞电泳迁移试验具有高度确定性,并能显示器官和原发肿瘤的可能定位(目前已在结肠癌、直肠癌和胃癌中得到验证)。然而,除了进一步研究原理外,在该试验能够在常规工作中更广泛应用之前,还需对其进行技术简化。

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