Schwartz M K
Department of Clinical Chemistry, Memorial Sloan Kettering Cancer Center, New York, NY 10021.
Clin Chem. 1993 Nov;39(11 Pt 2):2397-403.
Screening is defined as the presumptive identification of unrecognized disease or defect by the application of tests, examinations, or other procedures that can be applied rapidly and carried out in the general population or in individuals at high risk. When considering immunochemical or biochemical cancer markers, it might be more appropriate to describe these tests as risk-factor monitors and introduce the concept of two interpretations of these tests: in asymptomatic populations as indicators of probability of cancer, and in patients with previously treated cancer as predictors of recurrence despite initial treatment described as "curative." The successes of screening with alpha-fetoprotein for hepatocellular carcinoma and with catechol metabolites in neuroblastoma are discussed. The major emphasis will be the possible use of CA 125 and prostate-specific antigen (PSA) in risk-factor assessment of ovarian cancer and prostate cancer, respectively. It is important to understand in what context a PSA value > 10 micrograms/L indicates a 67% probability of cancer.
筛查被定义为通过应用能够快速实施且可在普通人群或高危个体中进行的检测、检查或其他程序，对未被识别的疾病或缺陷进行推定识别。在考虑免疫化学或生化癌症标志物时，将这些检测描述为风险因素监测指标并引入对这些检测的两种解释概念可能更为合适：在无症状人群中作为癌症发生概率的指标，在既往接受过癌症治疗的患者中作为尽管初始治疗被描述为“治愈性”但仍有复发预测指标。文中讨论了甲胎蛋白筛查肝细胞癌以及儿茶酚代谢产物筛查神经母细胞瘤的成功案例。主要重点将是CA 125和前列腺特异性抗原（PSA）分别在卵巢癌和前列腺癌风险因素评估中的可能应用。了解在何种情况下PSA值>10微克/升表明患癌概率为67%很重要。
