title: National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for use of tumor markers in liver, bladder, cervical, and gastric cancers.
abstract: BACKGROUND
  Updated National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for the use of tumor markers in the clinic have been developed.
  
  
  METHODS
  Published reports relevant to use of tumor markers for 4 cancer sites--liver, bladder, cervical, and gastric--were critically reviewed.
  
  
  RESULTS
  Alpha-fetoprotein (AFP) may be used in conjunction with abdominal ultrasound for early detection of hepatocellular carcinoma (HCC) in patients with chronic hepatitis or cirrhosis associated with hepatitis B or C virus infection. AFP concentrations >200 microg/L in cirrhotic patients with typical hypervascular lesions >2 cm in size are consistent with HCC. After a diagnosis of HCC, posttreatment monitoring with AFP is recommended as an adjunct to imaging, especially in the absence of measurable disease. Although several urine markers have been proposed for bladder cancer, none at present can replace routine cystoscopy and cytology in the management of patients with this malignancy. Some may, however, be used as complementary adjuncts to direct more effective use of clinical procedures. Although carcinoembryonic antigen and CA 19-9 have been proposed for use gastric cancer and squamous cell carcinoma antigen for use in cervical cancer, none of these markers can currently be recommended for routine clinical use.
  
  
  CONCLUSIONS
  Implementation of these recommendations should encourage optimal use of tumor markers for patients with liver, bladder, cervical, or gastric cancers.
authors.affiliation: Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, UK. C.Sturgeon@ed.ac.uk
authors.forename: Catharine M
authors.initials: CM
authors.lastname: Sturgeon
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Duffy
authors.forename: Barry R
authors.initials: BR
authors.lastname: Hofmann
authors.forename: Rolf
authors.initials: R
authors.lastname: Lamerz
authors.forename: Herbert A
authors.initials: HA
authors.lastname: Fritsche
authors.forename: Katja
authors.initials: K
authors.lastname: Gaarenstroom
authors.forename: Johannes
authors.initials: J
authors.lastname: Bonfrer
authors.forename: Thorsten H
authors.initials: TH
authors.lastname: Ecke
authors.forename: H Barton
authors.initials: HB
authors.lastname: Grossman
authors.forename: Peter
authors.initials: P
authors.lastname: Hayes
authors.forename: Ralf-Thorsten
authors.initials: RT
authors.lastname: Hoffmann
authors.forename: Seth P
authors.initials: SP
authors.lastname: Lerner
authors.forename: Florian
authors.initials: F
authors.lastname: Löhe
authors.forename: Johanna
authors.initials: J
authors.lastname: Louhimo
authors.forename: Ihor
authors.initials: I
authors.lastname: Sawczuk
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Taketa
authors.forename: Eleftherios P
authors.initials: EP
authors.lastname: Diamandis
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood / Q000652:urine; D019411:Clinical Laboratory Techniques / Q000592:standards*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D013274:Stomach Neoplasms / Q000175:diagnosis*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins