National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for use of tumor markers in liver, bladder, cervical, and gastric cancers.
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.
Sturgeon
Catharine M
CM
Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, UK. C.Sturgeon@ed.ac.uk
Duffy
Michael J
MJ
Hofmann
Barry R
BR
Lamerz
Rolf
R
Fritsche
Herbert A
HA
Gaarenstroom
Katja
K
Bonfrer
Johannes
J
Ecke
Thorsten H
TH
Grossman
H Barton
HB
Hayes
Peter
P
Hoffmann
Ralf-Thorsten
RT
Lerner
Seth P
SP
Löhe
Florian
F
Louhimo
Johanna
J
Sawczuk
Ihor
I
Taketa
Kazuhisa
K
Diamandis
Eleftherios P
EP
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
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins