Kolorektal Kanserlerin Tanı ve Prognostik Takibinde Eski ve Yeni Serum Biyobelirteçleri: Sistematik İnceleme ve Meta-Analiz

Yıl 2019, Sayı: 9, 902 - 919, 31.12.2019

Muhammed Zübeyr Üçüncü

https://doi.org/10.38079/igusabder.592956

Öz

Bu mini derleme ve sistematik meta analizde kolorektal karsinomun tanısında ya da prognozunda araştırılmış olan bazı biyobelirteçlerin irdelenmesi amaçlanmıştır. Yapılan analizler karsinoembriyonik antijenin (CEA) kolorektal karsinom tanısında orta duyarlılık ve yüksek özgüllük değerlerinde olduğunu, ancak kolorektal kanseri yakalamakta yetersiz olduğunu, prognozun belirlenmesinde kullanılabileceğini göstermektedir. Karbonhidrat Antijeni 19-9’un (CA19-9) tek başına kolorektal karsinom taramasında, tanısında, prognozunun belirlenmesinde veya nükslerin yakalanmasında kullanılamayacağı, diğer belirteçlerle birlikte kullanıldığında bilgi sağlayıcı olabileceği görülmüştür. Kanser Antijeni 242’nin (CA242) kolorektal karsinom tanısında ve prognozunun belirlenmesinde özellikle CEA ve/veya CA19-9 gibi farklı tümör belirteçleriyle birlikte kullanılabileceği gösterilmiştir. C-reaktif Proteininin (CRP) inflamasyon için spesifik bir belirteç olduğu, kolorektal karsinom gelişme riskini belirlemede, tanı koymada ve prognozu anlamada kullanılabileceğini ancak kolorektal karsinoma özgül bir belirteç olmadığı görülmüştür. Vasküler Endotelyal Büyüme Faktörü (VEGF) ile kolorektal karsinomun ilişkili olduğu ve VEGF’in bu olgularda tanıda ve prognozu belirlemede belirteç olarak kullanılabileceği ortaya konulmuştur. MicroRNA’ların kolorektal karsinom taramasında, tanısında ve prognozunun belirlenmesinde kullanılabileceği gösterilmiştir. Diğer belirteçlerden Kanser Antijeni 50 (CA-50), İnsülin Benzeri Büyüme Faktörü Bağlanma Proteini 3 (IGFBP-3),  İnsülin Benzeri Büyüme Faktörü-1’i (IGF-1), Kanser Antijeni 72-4’ün (CA72-4), Tümör İlişkili Glikoprotein-72 (TAG-72), P53, Kanser Antijeni 125’in (CA125), c-erbB-2 proteini, Doku Metalloproteinaz İnhibitörü-1’in (TIMP-1) ve Pirüvat Kinaz İzoenzimi M2’nin (M2-PK) kolorektal karsinomda sınırlı oranda kullanılabileceği görülmüştür. Kolorektal karsinomların taranmasında, tanısında, izleminde ve prognozunun belirlenmesinde ileri derecede güvenilir bir biyobelirteç henüz belirlenebilmiş değildir. Ancak belirteçlerin araştırılması değişik duyarlılık ve özgüllük oranlarına rağmen klinisyen ve hasta için büyük fayda sağlamaktadır. Özellikle bazı belirteçlerin kombine kullanımının bu olgularda önemli yarar sağladığı görülmüştür.

Anahtar Kelimeler

Kolorektal karsinom, CEA, CA19-9, CA242, microRNA, tanı, prognostik faktör

Former and Recent Serum Biomarkers in Diagnosis and Prognostic Follow-up of Colorectal Cancers: Systematic Review and Meta-Analysis

Öz

This mini review and systematic meta-analysis aimed to investigate some biomarkers that have been investigated in the diagnosis or prognosis of colorectal carcinoma. Analyzes show that carcinoembryonic antigen (CEA) has moderate sensitivity and high specificity in the diagnosis of colorectal carcinoma, but it is insufficient to detect colorectal cancer and can be used to determine prognosis. Carbohydrate Antigen 19-9 (CA19-9) alone cannot be used for colorectal carcinoma screening, diagnosis, prognosis or detection of relapses, and it can be used when used in conjunction with other markers. It has been shown that Cancer Antigen 242 (CA242) can be used in combination with different tumor markers such as CEA and / or CA19-9 in the diagnosis and prognosis of colorectal carcinoma. C-reactive protein (CRP) is a specific marker for inflammation, it can be used to determine the risk of developing colorectal carcinoma, to diagnose and to understand prognosis, but it is not a specific marker of colorectal carcinoma. Vascular Endothelial Growth Factor (VEGF) is associated with colorectal carcinoma and VEGF can be used as a marker in the diagnosis and prognosis of these cases. It has been shown that microRNAs can be used for colorectal carcinoma screening, diagnosis and prognosis. Other markers include Cancer Antigen 50 (CA-50), Insulin Like Growth Factor Binding Protein 3 (IGFBP-3), Insulin Like Growth Factor-1 (IGF-1), Cancer Antigen 72-4 (CA72-4). Tumor Related Glycoprotein-72 (TAG-72), P53, Cancer Antigen 125 (CA125), c-erbB-2 protein, Tissue Metalloproteinase Inhibitor-1 (TIMP-1) and Pyruvate Kinase Isoenzyme M2 (M2-PK) have been shown to be limited in colorectal carcinoma. A highly reliable biomarker for screening, diagnosis, follow-up and prognosis of colorectal carcinomas has not yet been established. However, the search for markers is of great benefit to the clinician and the patient, despite varying sensitivity and specificity rates. In particular, the combined use of some markers has been shown to provide significant benefit in these cases.

Anahtar Kelimeler

Colorectal carcinoma, CEA, Ca19-9, CA 242, Micro RNA, prognostic factor

Kaynakça

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