National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers
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DOI：
10.1373/clinchem.2008.105601
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发表时间：
2008-12-01
影响因子：
9.3
通讯作者：
Diamandis, Eleftherios P.
中科院分区：
文献类型：
--
作者：
Sturgeon, Catharine M.;Duffy, Michael J.;Diamandis, Eleftherios P.
背景：最新的国家临床生物化学学会（NACB）实验室医学实践指南已经制定了肿瘤标志物在临床中的使用。方法：对已发表的有关肿瘤标志物在5种癌症部位（睾丸、前列腺、结直肠癌、乳腺癌和卵巢）使用的报道进行了批判性回顾。结果：对于睾丸癌，甲胎蛋白、人绒毛膜促性腺激素和乳酸脱氢酶被推荐用于诊断/病例发现、分期、预后确定、复发检测和治疗监测。甲胎蛋白也被推荐用于非半精细胞瘤和半精细胞瘤生殖细胞瘤的鉴别诊断。前列腺特异性抗原（PSA）不推荐用于前列腺癌筛查，但可用于检测疾病复发和监测治疗。当总PSA < 10 μ g/L时，游离PSA测量数据可用于区分恶性和良性前列腺疾病。在结直肠癌中，癌胚抗原被推荐（有一些注意事项）用于预后判断、术后监测和晚期疾病的治疗监测。粪便隐血试验可用于筛选无症状的成年人50岁或以上。对于乳腺癌，雌激素和孕激素受体是预测激素治疗反应的强制性指标，人表皮生长因子受体-2测量是预测曲妥珠单抗反应的强制性指标，尿激酶纤溶酶原激活剂或纤溶酶原激活剂抑制剂1可用于确定淋巴结阴性患者的预后。或癌胚抗原可用于晚期疾病的治疗监测。CA125被推荐用于卵巢癌高危妇女的早期检测（经阴道超声）。CA125也被推荐用于绝经后妇女可疑盆腔肿块的鉴别诊断，以及卵巢癌复发的检测、治疗的监测和预后的确定。结论：这些建议的实施应鼓励肿瘤标志物的最佳使用。
BACKGROUND: Updated National Academy of ClinicalBiochemistry (NACB) Laboratory Medicine PracticeGuidelines for the use of tumor markers in the clinichave been developed.METHODS: Published reports relevant to use of tumormarkers for 5 cancer sites-testicular, prostate, colorectal,breast, and ovarian-were critically reviewed.RESULTS: For testicular cancer, alpha-fetoprotein, humanchorionic gonadotropin, and lactate dehydrogenaseare recommended for diagnosis/case finding, staging,prognosis determination, recurrence detection, and therapymonitoring. alpha-Fetoprotein is also recommended fordifferential diagnosis of nonseminomatous and seminomatousgerm cell tumors. Prostate-specific antigen(PSA) is not recommended for prostate cancer screening,but may be used for detecting disease recurrenceand monitoring therapy. Free PSA measurement dataare useful for distinguishing malignant from benignprostatic disease when total PSA is < 10 mu g/L. In colorectalcancer, carcinoembryonic antigen is recommended(with some caveats) for prognosis determination, postoperativesurveillance, and therapy monitoring in advanceddisease. Fecal occult blood testing may be used for screening asymptomatic adults 50 years or older. Forbreast cancer, estrogen and progesterone receptors aremandatory for predicting response to hormone therapy,human epidermal growth factor receptor-2 measurementis mandatory for predicting response to trastuzumab,and urokinase plasminogen activatorplasminogen activator inhibitor 1 may be used fordetermining prognosis in lymph node-negative patients.or carcinoembryonic antigenmay be used for therapy monitoring in advanced disease.CA125 is recommended (with transvaginal ultrasound)for early detection of ovarian cancer in womenat high risk for this disease. CA125 is also recommendedfor differential diagnosis of suspicious pelvicmasses in postmenopausal women, as well as for detectionof recurrence, monitoring of therapy, and determinationof prognosis in women with ovarian cancer.CONCLUSIONS: Implementation of these recommendationsshould encourage optimal use of tumor markers.