How to integrate serum tumor markers into clinical oncologic practice.
Several serum tumor markers have been studied in different types of epithelial cell-associated cancer. The application of these markers in clinical oncologic practice is hampered by insufficient sensitivity and specificity in most primary tumors. It is important to define which markers contribute to patient management. Prostate-specific antigen can be used in prostate cancer patients for screening and monitoring advanced disease. Cancer antigen 125 is primarily used for the monitoring of combined chemotherapy in ovarian cancer patients. In breast cancer patients preoperative levels of cancer antigen 15-3, carcinoembryonic antigen, and tissue polypeptide antigen specific do not contribute in prognosis, but changes in the levels of these markers predict the clinical outcome in the treatment of advanced disease better than UICC criteria. Carcinoembryonic antigen and tissue polypeptide antigen specific can detect recurrence in colorectal cancer patients earlier than imaging methods. Tissue polypeptide antigen specific is sensitive in measuring response to combined chemotherapy in advanced gastrointestinal cancer. In bladder cancer, urine levels of cytokeratins are sensitive in indicating advanced disease. In small-cell lung cancer neuron-specific enolase is a good indicator of chemotherapy response. In non-small-cell lung cancers, cytokeratins may also predict response in chemotherapy treatment. Clinical application of tumor markers in the correct circumstances can omit more invasive and costly procedures and will contribute to better patient care.
van Dalen
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Groene Hart Ziekenhuis, Department of Nuclear Medicine, Gouda, The Netherlands.
D014408:Biomarkers, Tumor / Q000097:blood*; D006801:Humans; D008495:Medical Oncology; D009369:Neoplasms / Q000097:blood*
D014408:Biomarkers, Tumor