Consensus on biomarkers for neuroendocrine tumour disease.
Consensus on biomarkers for neuroendocrine tumour disease.
复制标题
DOI：
10.1016/s1470-2045(15)00186-2
复制
发表时间：
2015-09
期刊：
影响因子：
51.1
通讯作者：
Goldenring, James
中科院分区：
文献类型：
--
作者：
Oberg, Kjell;Modlin, Irvin M.;De Herder, Wouter;Pavel, Marianne;Klimstra, David;Frilling, Andrea;Metz, David C.;Heaney, Anthony;Kwekkeboom, Dik;Strosberg, Jonathan;Meyer, Timothy;Moss, Steven F.;Washington, Kay;Wolin, Edward;Liu, Eric;Goldenring, James
神经内分泌瘤的管理是一个临床挑战，因为它的晚期表现，缺乏治疗选择，并在目前的成像方式和生物标志物的限制，以指导管理。单分析物生物标志物具有较差的灵敏度、特异性和预测能力。2007年举行的国家癌症研究所神经内分泌肿瘤峰会指出，生物标志物的局限性是神经内分泌肿瘤管理中一个关键的未满足需求。神经内分泌肿瘤多学科专家的多国共识会议评估了当前生物标志物的使用，并通过德尔菲方法定义了新生物标志物的额外条件。107个评估问题中有88个（82%）达成共识（>75%）。专家组得出结论，循环多分析物生物标志物提供了最低限度疾病检测所需的最高灵敏度和特异性，并且这种类型的生物标志物具有足够的信息来预测治疗有效性和预后。专家组还得出结论，神经内分泌肿瘤的单分析物生物标志物尚未满足这些标准，并且没有足够的信息支持miRNA或循环肿瘤细胞作为该疾病有用的预后标志物的临床用途。专家组认为，测量多分析物（如神经内分泌基因转录物）的试验还应确定这些信息如何优化神经内分泌肿瘤患者的管理。
Management of neuroendocrine neoplasia represents a clinical challenge because of its late presentation, lack of treatment options, and limitations in present imaging modalities and biomarkers to guide management. Monoanalyte biomarkers have poor sensitivity, specificity, and predictive ability. A National Cancer Institute summit, held in 2007, on neuroendocrine tumours noted biomarker limitations to be a crucial unmet need in the management of neuroendocrine tumours. A multinational consensus meeting of multidisciplinary experts in neuroendocrine tumours assessed the use of current biomarkers and defined the perquisites for novel biomarkers via the Delphi method. Consensus (at >75%) was achieved for 88 (82%) of 107 assessment questions. The panel concluded that circulating multianalyte biomarkers provide the highest sensitivity and specificity necessary for minimum disease detection and that this type of biomarker had sufficient information to predict treatment effectiveness and prognosis. The panel also concluded that no monoanalyte biomarker of neuroendocrine tumours has yet fulfilled these criteria and there is insufficient information to support the clinical use of miRNA or circulating tumour cells as useful prognostic markers for this disease. The panel considered that trials measuring multianalytes (eg, neuroendocrine gene transcripts) should also identify how such information can optimise the management of patients with neuroendocrine tumours.