Glimelius B, Hoffman K, Einarsson R, Pählman L, Graf W
Department of Oncology, Uppsala University, Sweden.
Acta Oncol. 1996;35(2):141-8. doi: 10.3109/02841869609098494.
Tissue polypeptide antigen specific (TPS) was analysed in serum taken prior to chemotherapy in 90 patients with advanced gastrointestinal cancer and prior to every treatment course in 68 of these patients in order to explore whether serial tumour marker measurements can be of importance in monitoring patients treated with palliative chemotherapy. Elevated TPS levels were seen in 83/90 (92%) patients (48/52 colorectal, 9/9 pancreatic, 9/11 biliary, 17/18 gastric). Baseline TPS level correlated with performance status, tumour response and survival. Based upon the change in TPS levels after the first two courses in relation to baseline, a decrease by >50% had a high sensitivity for a favourable treatment outcome (partial remission and prolonged stationary disease (90%) or a subjective response (100%)), whereas the specificity was lower (72% and 73% respectively). A similar result was seen when the TPS levels were analysed at the time of the response evaluation after 2 months (sensitivity 91 and 95%, specificity 74 and 75% for an objective or subjective response respectively). In 7 out of 15 patients with an initially favourable outcome, an increase in TPS levels of >50% at two occasions was seen 8-20 weeks prior to clinical disease progression. In advanced gastrointestinal cancer serial TPS measurements can with high accuracy early identify patients who will not benefit from the treatment. On the other hand, a response must be confirmed using other methods in the presence of a decrease, since this was also seen in non-responding patients.
对90例晚期胃肠道癌患者化疗前及其中68例患者每个疗程治疗前采集的血清进行组织多肽抗原特异性（TPS）分析，以探讨连续肿瘤标志物检测在监测姑息化疗患者中是否具有重要意义。83/90（92%）例患者TPS水平升高（48/52例结直肠癌、9/9例胰腺癌、9/11例胆管癌、17/18例胃癌）。基线TPS水平与体能状态、肿瘤反应和生存相关。根据前两个疗程后TPS水平相对于基线的变化，下降>50%对良好的治疗结果（部分缓解和疾病稳定期延长（90%）或主观反应（100%））具有较高的敏感性，而特异性较低（分别为72%和73%）。在2个月后的反应评估时分析TPS水平时也得到了类似结果（客观或主观反应的敏感性分别为91%和95%，特异性分别为74%和75%）。15例初始结果良好的患者中有7例在临床疾病进展前8 - 20周出现两次TPS水平升高>50%。在晚期胃肠道癌中，连续TPS检测可高精度地早期识别出无法从治疗中获益的患者。另一方面，在出现下降时必须使用其他方法来确认反应，因为在无反应的患者中也会出现这种情况。
