肿瘤标志物检测要点.ppt

* * * * * EML The ideal tumor marker should have 100% sensitivity and 100% specificity should be secreted into blood in measurable concentration only after the cells that produce it had undergone malignant transformation. is present in serum and should allow to locate the tumor in the body. ? The ideal tumor marker does not exist ! * To show you HE4 as an example here: Oncological biomarkers are not necessarily ?normal“ for the individual patient, if the values are within the reference range Recurrent increase in the tumor marker concentration and speed of the marker increase? highly indicative for tumor progression or metastatic disease? kinetic-based interpretation during follow up based upon individual baseline  values avoids false positive and false negative test results Diagnostic capacity of biomarkers ? for the early detection of recurrent or metastatic disease does not depend on the release  of these biomarkers by the primary tumor! 100% increase based on the individual baseline values of the patients means almost 100% tumor specificity * Combining the relevant biomarkers? increase of the diagnostic capacity for the detection of metastatic disease Important guidelines for use of tumor markers in the clinic are existing from several organizations and key stakeholder groups. The most prominent ones are from ASCO (American Society of Clinical Oncologists), NACB (National Academy of Clinical Biochemists) and from the EGTM (European Group on Tumor Markers) * Contents  肿瘤标志物基础知识 肿瘤标志物项目简介 肿瘤标志物合理应用 肿瘤标志物的合理应用 筛查 / 早期诊断 诊断 – 鉴别诊断 治疗的监测 随访 – 早期发现肿瘤复发和转移 预后 page * ? 2011 Roche 肿瘤标志物的合理应用1) 肿瘤的早期诊断 PSA 大于50岁的男性-联合直肠指诊（DRE) AFP 肝癌高危人群 AFP 和 HCG 生殖细胞肿瘤的高风险人群 TG 和 降钙素 甲状腺癌的诊断 page * ? 2011 Roche 肿瘤标志物的合理应用 例如：AFP对HCC具有很好的诊断价值 page * ? 2012 Roche 肿瘤标志物的合理应用 筛查 / 早期诊断 诊断 – 鉴别诊断 治疗的监测 随访 – 早期发现肿瘤复发和转移 预后 page * ? 2011 Roche 肿瘤标志物的合理应用2) 肿瘤的诊断 CYFRA 21-1 高水平提示肺癌 NSE和 proGRP 分型不明确的肺癌 ProGRP 或 NSE 水平极高提示小细胞肺癌 CA 15-3常与C