Kozwich D L, Kramer L C, Mielicki W P, Fotopoulos S S, Gordon S G
University of Colorado Health Sciences Center, Department of Pathology 80262.
Cancer. 1994 Aug 15;74(4):1367-76. doi: 10.1002/1097-0142(19940815)74:4<1367::aid-cncr2820740430>3.0.co;2-y.
In spite of many advances in the analytical reagents (antibodies), analytical systems, and the clinical application of tumor markers, the present markers do not detect early stage cancer. Preliminary data with an antigen specific to tumor tissue, cancer procoagulant (CP), suggest its possible role in the detection of early stage cancer. This study was aimed at determining the clinical use of CP as an early stage tumor marker.
An improved enzyme-linked immunosorbent assay (ELISA) was developed to measure CP concentration in serum. A panel of 817 blinded serum samples were examined from three groups of people: 573 cancer, 106 benign, and 139 normal.
The sensitivity of all samples analyzed from cancer patients was 80%. The CP ELISA was able to detect ovarian, colon, and kidney cancer at a sensitivity greater than 85%; breast, prostate and small cell lung cancer was detected at a sensitivity of 80-85%. Particularly interesting was the observation that early stage cancers, regardless of site, were detected effectively. In some groups, the CP assay correctly identified 100% of the patients with stage I and II cancer. The assay was able to identify correctly noncancer patient sera at a specificity of 83% for those with benign disease and 82% for the normal individuals.
The CP assay has potential as an aid in diagnosing early stage malignancies and thereby may significantly improve the survival rate of cancer patients.
尽管在分析试剂(抗体)、分析系统以及肿瘤标志物的临床应用方面取得了许多进展,但目前的标志物无法检测出早期癌症。一种针对肿瘤组织的特异性抗原——癌促凝素(CP)的初步数据表明,它可能在早期癌症检测中发挥作用。本研究旨在确定CP作为早期肿瘤标志物的临床应用价值。
开发了一种改进的酶联免疫吸附测定(ELISA)法来测量血清中CP的浓度。对来自三组人群的817份盲法血清样本进行了检测:573例癌症患者、106例良性疾病患者和139例正常个体。
分析的所有癌症患者样本的敏感性为80%。CP ELISA能够检测出卵巢癌、结肠癌和肾癌,敏感性大于85%;乳腺癌、前列腺癌和小细胞肺癌的检测敏感性为80 - 85%。特别有趣的是观察到,无论癌症发生部位如何,早期癌症都能被有效检测出来。在一些组中,CP检测正确识别了100%的I期和II期癌症患者。该检测能够正确识别非癌症患者血清,对良性疾病患者的特异性为83%,对正常个体的特异性为82%。
CP检测有潜力辅助诊断早期恶性肿瘤,从而可能显著提高癌症患者的生存率。