Kornek G, Schenk T, Raderer M, Djavarnmad M, Scheithauer W
Department of Internal Medicine I, Vienna University Medical School, Austria.
Br J Cancer. 1995 Jan;71(1):182-5. doi: 10.1038/bjc.1995.37.
The new proliferation marker, tissue polypeptide-specific antigen (TPS), representing the specific epitope M3 of tissue polypeptide antigen, and three conventional biochemical markers, CEA, CA 19-9 and CA-195, were analysed in 69 patients with advanced gastrointestinal tumours. The aim of our study was to assess the clinical relevance of these markers and to determine whether their use in monitoring the course of the disease can reduce the need for serial imaging procedures. At baseline, pathologically elevated TPS levels occurred in 90% of patients. CEA was elevated in 73%, CA 19-9 in 59% and CA-195 in 68%. With a detection rate of > 90% in both advanced colorectal (n = 37) and pancreatic cancer (n = 20), and of 75% in gastric cancer (n = 12), TPS was the most sensitive marker in all three tumour types included in this analysis. Serial evaluations of TPS and other biochemical markers were available in 39 patients undergoing palliative systemic chemotherapy. Treatment with a fluorouracil-based regimen resulted in a partial response in 5/27 patients with colorectal cancer, whereas 2/12 patients with pancreatic cancer responded to therapy with a high-dose epirubicin combination regimen. All other patients had disease stabilisation or suffered from progressive disease. When compared with the results of serial CT scanning, the TPS correlated best with the course of the disease, the positive predictive value being 75% for a partial response, 96% for stable disease and partial response combined and 100% for progressive disease. The corresponding values for CEA were 50%, 81% and 62% and were similar to those for CA 19-9 and CA-195. In summary, TPS seems to represent a sensitive, clinically relevant and specific marker of proliferative activity in gastrointestinal cancer. According to our preliminary results in colorectal and pancreatic cancer, TPS may be considered as the primary means of monitoring treatment, and imaging reduced to confirm the response.
对69例晚期胃肠道肿瘤患者分析了新的增殖标志物组织多肽特异性抗原（TPS），它代表组织多肽抗原的特异性表位M3，以及三种传统生化标志物癌胚抗原（CEA）、糖类抗原19-9（CA 19-9）和糖类抗原195（CA-195）。本研究的目的是评估这些标志物的临床相关性，并确定其用于监测疾病进程是否可减少系列成像检查的必要性。基线时，90%的患者TPS水平病理性升高。CEA升高的患者占73%，CA 19-9升高的患者占59%，CA-195升高的患者占68%。在晚期结直肠癌（n = 37）和胰腺癌（n = 20）中，TPS的检出率均> 90%，在胃癌（n = 12）中为75%，在本分析纳入的所有三种肿瘤类型中，TPS是最敏感的标志物。39例接受姑息性全身化疗的患者可进行TPS和其他生化标志物的系列评估。基于氟尿嘧啶的方案治疗使5/27例结直肠癌患者部分缓解，而2/12例胰腺癌患者对高剂量表柔比星联合方案治疗有反应。所有其他患者疾病稳定或病情进展。与系列CT扫描结果相比，TPS与疾病进程的相关性最佳，部分缓解的阳性预测值为75%，疾病稳定和部分缓解合并的阳性预测值为96%，病情进展的阳性预测值为100%。CEA的相应值分别为50%、81%和62%，与CA 19-9和CA-195的值相似。总之，TPS似乎是胃肠道癌增殖活性的一种敏感、临床相关且特异的标志物。根据我们在结直肠癌和胰腺癌中的初步结果，TPS可被视为监测治疗的主要手段，而成像检查可减少至仅用于确认反应。
