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© 2010 American Association for Clinical Chemistry, Inc.
Special Reports |
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Liver, Bladder, Cervical, and Gastric Cancers
1 Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, UK; 2 Department of Pathology and Laboratory Medicine, St Vincent’s University Hospital and UCD School of Medicine and Medical Science, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland; 3 Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada; 4 Department of Medicine, LMU-Klinikum-Grosshadern, University of Munich, Germany; 5 Department of Laboratory Medicine, the University of Texas M. D. Anderson Cancer Center, Houston, TX; 6 Department of Gynecology, Leiden University Medical Center, Leiden, the Netherlands; 7 Department of Clinical Chemistry, Netherlands Cancer Institute, Amsterdam, the Netherlands; 8 Department of Urology, Helios Hospital, Bad Saarow, Germany; 9 Department of Urology, the University of Texas M. D. Anderson Cancer Center, Houston, TX; 10 Scottish Liver Transplant Unit, Department of Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK; 11 Department of Clinical Radiology, LMU-Klinikum-Grosshadern, University of Munich, Germany; 12 Department of Surgery, LMU-Klinikum-Grosshadern, University of Munich, Germany; 13 Department of Urology, Baylor College of Medicine, Houston, Texas; 14 Department of Clinical Chemistry, Helsinki University Central Hospital, Finland; 15 Department of Urology, Hackensack University Medical Center, Hackensack, New Jersey; 16 Clinical Trial Center, Brain Attack Center, Oota Memorial Hospital, Fukuyama, Japan.
aAddress correspondence to this author at: the Department of Clinical Biochemistry, Royal Infirmary, Edinburgh EH16 4SA, UK. Fax +44-1311-242-6882; e-mail C.Sturgeon{at}ed.ac.uk.
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: 
-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 µg/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.
The following articles in journals at HighWire Press have cited this article:
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  E. P. Diamandis Cancer Biomarkers: Can We Turn Recent Failures into Success? J Natl Cancer Inst, August 12, 2010; (2010) djq306v1. [Abstract] [Full Text] [PDF]
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