Lukinac L, Bolanca A, Nöthig-Hus D, Kusić Z
Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
Acta Med Croatica. 1997;51(2):73-7.
In addition to clinical examination and various diagnostic procedures, patients with gastrointestinal cancer (GIC) were also monitored by tumor marker (TM) determination. In total, 202 patients with GIC were postoperatively followed-up. According to in vivo diagnostic procedures, there were 133 (66%) patients without metastases, 63 (31%) patients with distant metastases, 48 (76%) of them with liver metastases, and six (3%) patients with local recurrences. During the 1990-1995 period, they were followed-up by serum TM concentration measurements on 1-8 occasions. At the time of initial diagnosis, TM were determined in a varying percent of the patients: CA 19-9 (100%), TPA (54%), CA 72-4 (49%), IAP (41%), CEA (41%) and AFP (25%). In the group of patients without metastases, the percentage of normal TM values ranged between 73%-100%, and TM sensitivity between 0%-86%. No ideal TM has as yet been discovered either for any malignant disease or for patients with GIC. Therefore, in the follow-up of patients with GIC we suggest the concentrations of at least two instead of only one TM (CA 19-9 and TPA or CEA) to be determined. It is also difficult to choose the best TM among numerous TM kits available on the market and to keep using it during a longitudinal follow-up study.
除了临床检查和各种诊断程序外，胃肠道癌（GIC）患者还通过肿瘤标志物（TM）测定进行监测。总共对202例GIC患者进行了术后随访。根据体内诊断程序，有133例（66%）患者无转移，63例（31%）患者有远处转移，其中48例（76%）有肝转移，6例（3%）患者有局部复发。在1990 - 1995年期间，对他们进行了1 - 8次血清TM浓度测量随访。在初次诊断时，不同百分比的患者测定了TM：CA 19 - 9（100%）、TPA（54%）、CA 72 - 4（49%）、IAP（41%）、CEA（41%）和AFP（25%）。在无转移的患者组中，TM值正常的百分比在73% - 100%之间，TM敏感性在0% - 86%之间。对于任何恶性疾病或GIC患者，尚未发现理想的TM。因此，在GIC患者的随访中，我们建议测定至少两种而非仅一种TM（CA 19 - 9和TPA或CEA）的浓度。在市场上众多的TM检测试剂盒中选择最佳的TM并在纵向随访研究中持续使用也很困难。
