Hayes D F
Breast Evaluation Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
Ann Oncol. 1993 Dec;4(10):807-19. doi: 10.1093/oxfordjournals.annonc.a058385.
Many antigenic and genetic markers have been proposed for breast cancer, with potential utility in identification, screening, prognosis, detection, or monitoring. Of the available markers, those with the greatest promise in 1993 include the yet-to-be-cloned BrCa1, the p53 tumor suppressor gene, tissue-associated prognostic factors such as HER-2/neu, cathepsin-D, and indicators of angiogenesis, and circulating tumor markers that provide an indication of clinical course, such as CA15-3 and CEA. However, the precise clinical utilities of all of these markers have yet to be determined. It is especially important that the relative independence of the markers in relation to other available markers to determined so as to avoid the unnecessary cost and expense of redundancy. Moreover, it is important that the clinician be aware of the limitations in both sensitivity and specificity of each marker so as not to sensitivity and specificity of each marker so as not to over- or under-interpret the predictive value of any test. With these caveats in mind, judicial application of germ-line, tissue, and soluble tumor markers can improve clinical care of patients at risk for and with breast cancer.
许多抗原和基因标志物已被提出用于乳腺癌，在识别、筛查、预后、检测或监测方面具有潜在用途。在现有的标志物中，1993年最具前景的标志物包括尚未克隆的BrCa1、p53肿瘤抑制基因、组织相关的预后因素，如HER-2/neu、组织蛋白酶-D以及血管生成指标，还有能够提供临床病程指示的循环肿瘤标志物，如CA15-3和CEA。然而，所有这些标志物的确切临床效用尚未确定。特别重要的是要确定这些标志物相对于其他现有标志物的相对独立性，以避免冗余带来的不必要成本和费用。此外，临床医生必须了解每个标志物在敏感性和特异性方面的局限性，以免对任何检测的预测价值过度解读或解读不足。牢记这些注意事项，合理应用种系、组织和可溶性肿瘤标志物可改善有乳腺癌风险的患者以及乳腺癌患者的临床护理。
