肺癌标志物筛查和癌症风险评估.pptVIP

结论 在基层医院，应用肿瘤标志物谱（ProGRP+SCC+CYFRA211+CEA）可以提高肺癌早期诊断率 在综合医院，联合肿瘤标志物谱和CT检查，可以提高肺癌早期诊断率 临床肿瘤标志物的检测具有一定成本效果 * 总结 运用肿瘤标志物评估癌症风险，早期识别高危人群，缩短诊断周期 合理优化的使用肿瘤标志物，最大程度发挥肿瘤标志物的临床价值 不断涌现的新型肿瘤标志物拓展了标志物的临床实践价值 知识回顾Knowledge Review * * 肺癌比例最高，原因2/3在中晚期被检出，没有合适的筛查模式，临床过分依赖影像结果，影像结果不利于肺癌早期检出 前列腺癌比例最低，绝大多数患者在早期检出，肿瘤标志物作为一线筛查功不可没 * Lung cancer 336.4 +/- 925.4 vs benign 40.1 +/=11.5 SCLC?? proGRP? ???? ????? ??(?? ??) * The current methods can be divided into two types: Imaged based and Microscopic Imaged based methods Chest X-ray First test ordered to look for spots on one’s lungs CT Scan (Computed Tomography) Helps to give precise information about the size, shape, and position of a tumor, and can help find enlarged lymph nodes that might contain cancer MRI (Magnetic resonance imaging) MRI images are particularly useful in finding lung cancer that has spread to the brain or spinal cord through the use of radio waves and strong magnets PET (Positron emission tomography) To help see if cancer has spread to lymph nodes and/or when metastasis is suspected but the location is unknown through the use of a sugar containing a radioactive atom which is absorbed by cancer cells Microscopic Methods Biopsy (Current Gold Standard) Only true confirmatory diagnostic method to determine if an abnormal area is a pre-cancer, a true cancer, or neither. Tissue sample is removed and studied under a microscope. Sputum cytology A sample of phlegm is looked at under a microscope to see if cancer cells are present Bronchoscopy Used to take samples of tissue or fluids to see if cancer cells are present by inserting a lighted, flexible tube through the mouth and into the bronchi Thoracentesis and thoracoscopy Tests performed to check whether fluid around the lung is caused by cancer or by a condition such as heart failure or an infection 先从病程发展过程上看一下有无通过血检实现早期检出的可能性。 在前时间段中找到合适的标志物检测或合适的检测策略，就会对于肺癌的早期检出有非常大的帮助。 F. Olesen, British Journal of Cancer (2009) 101, S5 – S8 Here is the schematic o