THE CLINICAL USE OF TUMOUR MARKERS, WHEN SHOULD WE WANT THEM?

Yıl 2015, Cilt: 7 Sayı: 1, 124 - 127, 22.03.2015

Ersin Dumlu

Öz

Tumor markers are biochemical parameters that are associated with tumoral tissues and are detected in the body fluids. These markers are secreted into the body fluids, either by the tumoral tissue itself or as a result of the metabolic change that is caused by it. These measured values could be the manifestation of a malignant process, but not necessarily. They could be secreted due to completely benign causes such as inflammatory infections. But recently,there is an information pollution about tumor markers amongst our society and colleagues. Beyond that, we observe that many colleagues can order tumor marker levels without hesitation even for a routine control patient. It is our purpose to correct this information pollution about tumor markers, to clarify and remind problems such as what a tumor marker is, when and for whom to order it.

Anahtar Kelimeler

Laboratory, examination, tumor marker

TÜMÖR BELİRTEÇLERİNİN KLİNİK KULLANIMI; NE ZAMAN İSTEYELİM?

Öz

Tümör belirteçleri, tümör dokusuna bağlı olarak vücut sıvılarında tespit edilen çeşitli biyokimyasal parametrelerdir. Bu belirteçler ya tümör dokusunun kendisi tarafından ya da tümör dokusunun neden olduğu metabolik değişiminin sonucu olarak vücut sıvılarına salgılanırlar. Ölçülen bu değerler, malign bir oluşumun göstergesi olabilir, ancak kesin sebebi değildir. Bunlar inflamatuar enfeksiyonlar gibi tamamen benign sebeplerle de salınabilirler. Ancak günümüzde, tümör belirteçleri hakkında, gerek toplumumuzda gerekse de kendi meslektaşlarımız arasında bilgi kirliliği mevcuttur. Bunun da ötesinde, bir hastamız normal check up yani kontrol için kan vermeye bir sağlık kuruluşuna geldiğinde, çoğu meslektaşımızın hiçbir çekingesi olmadan, rutin kan istemleri arasında tümör belirteçlerini cesaretle istedikleri görülmektedir. Amacımız tümör belirteçleri ile ilgili bu bilgi kirliliğini düzeltmek, tümör belirteci nedir, ne zaman istenmelidir, hangi hasta gruplarında istenmelidir gibi sorunlara açıklık getirmek ve hatırlatmaktır.

Anahtar Kelimeler

Laboratuar, tetkik, tümör belirteci

Kaynakça

• 1. Catharine Sturgeon. Practice Guidelines for Tumor Marker Use in the Clinic. Clinical Chemistry 2002; 48: 1151–1159
• 2. Hayes DF, Bast RC, Desch CE, Fritsche H, Jr., Kemeny NE, Jessup JM, et al. Tumor marker utility grading system: a framework to evaluate clinical utility of tumor markers. J Natl Cancer Inst 1996;88:1456–1466.
• 3. Duffy MJ. Evidence for the clinical use of tumour markers. Ann Clin Bi-ochem 2004;41:370–377.
• 4. Hayes DF. Prognostic and predictive factors for breast cancer: translating technology to oncology. J Clin Oncol 2005;23:1596–1597.
• 5. ACOG Committee Opinion. The role of generalist obstetriciangynecologist in the early detection of ovarian cancer. Obstet Gynecol 2002; 100:1413-1416.
• 6. American Joint Committee on Cancer, AJCC cancer staging manual, 6th edition. New York, Berlin, Heidelberg: Springer- Verlag, 2009: 128-130
• 7. Gold P, Freedman SO. Spesific car-cinoembryogenic antigen of the human digestive system. J Exp Med 1965; 122:467.
• 8. Bast RC, Ravdin P, Hayes DF, Bates S, Fritsche H et al. 2000 up- date of recommendation for use of tumor markers in breast and colorectal cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol 2001; 19: 1865-1878.
• 9. Gilligan TD, Seidenfeld J, Basch EM, et al. American Society of Clinical Oncology 2009. Clinical practice guidelines on the uses of serum tumor markers in adult males with germ cell tumors. J Clin Oncol 2010; 28: 3388.
• 10. Khatcheressian JL, Wolff AC, Smith TJ, et al. American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol 2006; 24: 5091.
• 11. Bates SE. Clinical applications of serum tumor markers. Ann Intern Med. 1991;115:623–638.
• 12. Wu JT. Diagnosis and management of cancer using serologic tumor markers. In Henry JB, ed. Clinical Diagnosis and Management by Laboratory Methods. 20th ed. Philadelphia, PA: WB Saunders; 2001: 1028–1042.
• 13. Tetrault, GA. Laboratory statistics. In Henry JB, ed. Clinical Diagnosis and Management by Laboratory Methods. 20th ed. Philadelphia, PA: WB Saunders; 2001: 138–147.
• 14. Price CP, Allard J, Davies G, Daw-nay A, Duffy MJ, France M, et al. Pre- and post- analytical factors that may influence use of serum prostate specific antigen and its isoforms in a screening programme for prostate cancer. Ann Clin Biochem 2001;38: 188–216.
• 15. Sturgeon C, Dati F, Duffy, MJ, Has-holzner U, Klapdor R, Lamerz R, et al. Quality requirements and control: EGTM recommendations. Anticancer Res 1999;19:2791–4.
• 16.Fleisher M, Dnistrian AM, Sturgeon CM, Lamerz R, Wittliff JL. Practice guidelines and recommendations for use of tumor markers in the clinic. In: Diamandis EP, Fritsche H, Schwartz MK, Chan DW, eds. Tumor markers: physiology, patho-biology, technology and clinical applications. 1st Edition, Chicago: AACC Press, 2002:33–63.
• 17. Sturgeon CM. Tumor markers in the laboratory: closing the guidelinepractice gap. Clin Biochem 2001; 34:353–9.