Protein Tumor Markers

什么是生物标志物

生物标志物的定义为“可在体内或其产物中进行测定的、并可影响或预测结果或疾病发生率的任何物质、结构或过程¹ 。 特定的生理条件是以该条件特异性物质的存在或水平改变为表征的。比如蛋白质和肽等物质很容易被测定，因此常常将它们用作生物标志物。

肿瘤诊断学中的生物标志物

肿瘤标志物属生物标志物的一个子类，用以指示癌症发展。其中的多数标志物都会在正常细胞和肿瘤细胞中产生。在各类恶性肿瘤患者身上，它们在体液如尿液、唾液或血液中的水平通常明显高于正常水平。

正在使用的肿瘤标志物有很多种，并可根据其功能、检测方式或测定样品类型进行分类²³：

• 癌胚抗原
• 肿瘤相关抗原
• 激素和激素受体
• 酶和同工酶
• 血清和组织蛋白⁴
• 其他肿瘤标志物，如遗传标记和生物分子

一种完善的肿瘤标志物具有高度特异性，并能够可靠地将健康个体与癌症患者区分开来。它可能是一种通用的肿瘤标志物，也可能是某一特定恶性肿瘤的特异性肿瘤标志物。它应能够实现对早期肿瘤的早期检测，同时还可以区分肿瘤分期，并对结果和潜在复发具有预后价值。最后，它还应易于使用已有技术进行测定，以跟踪治疗期间的任何变化。

目前已确定的标志物中还没有一种能够满足上述完善肿瘤标志物愿望清单中的所有要求。通常会同时使用多种标志物，从而实现对多种不同癌症类型的可靠诊断、预后、分期和监测 ⁵。

如何测定肿瘤标志物

当前，大多数标志物均为蛋白质或肽类。因此，可以使用免疫学方法，如ELISA、免疫组织化学法、免疫荧光法、流式细胞术，或根据标志物和样品性质确定的其他方法，对它们进行定性和定量测定。

越来越多的肿瘤标志物也基于遗传变异⁶。表达模式的改变以及某些癌基因的突变不仅会影响恶性肿瘤的类型，而且也是治疗反应的决定因素。

Tumor marker related products

Marker class	Marker - click antigen for available products	Gene	Cancer type	IV
Oncofetal antigens	Alpha-fetoprotein	AFP	liver, germ cell tumors, ovarian, testicular
Oncofetal antigens	CEACAM 5	CEACAM5	esophageal, bile duct, colorectal, breast, thyroid
Oncofetal antigens	CEACAM6	CEACAM6	esophageal, bile duct, colorectal, breast, thyroid
Oncofetal antigens	Carcinoembryonic antigen (CEA)	CEACAM1	esophageal, bile duct, colorectal, breast, thyroid
Oncofetal antigens	Carcinoembryonic antigen (CEA)	CEACAM7	esophageal, bile duct, colorectal, breast, thyroid
Tumor associated antigens	5-HIAA	-	carcenoid
Tumor associated antigens	CA15-3	MUC1	breast
Tumor associated antigens	CA19-9	-	pancreatic, gallbladder, bile duct, gastric
Tumor associated antigens	CA72-4	-	bile duct, gastric cancer
Tumor associated antigens	CA125	MUC16	ovarian
Hormes and receptors	Chorionic Gonadotropin, beta Polypeptide (CGB)	CGA, CGB	choriocarcinoma, testicular
Hormes and receptors	Calcitonin	CALC1	medullary thyroid cancer
Hormes and receptors	Chromogranin A (CHGA)	CHGA	neuroendocrine tumors
Hormes and receptors	EGFR mutation analysis	EGFR	non-small cell lung cancer
Hormes and receptors	Estrogen receptor (ER)	ESR1	breast
Hormes and receptors	Estrogen receptor (ER)	ESR2	breast
Hormes and receptors	HER2/neu	ERBB2	breast, gastric, esophageal
Hormes and receptors	Osteocalcin	BGLAP	bone
Hormes and receptors	Progesterone receptor (PGR)	PGR	breast
Hormes and receptors	Transferrin Receptor	TFRC	breast
Hormes and receptors	Transthyretin	TTR	ovarian
Enzymes and modulators	Alkaline phosphatase (Bone)	ALPL	bone
Enzymes and modulators		BCR/ABL1	chronic myelogenous leukemia, acute lymphoblastic leukemia, acute myelogenous leukemia
Enzymes and modulators	BRAF V600E	BRAF	Cutaneous melanoma and colorectal cancer
Enzymes and modulators	KIT	KIT	gastrointestinal stromal tumor, mucosal melanoma
Enzymes and modulators	KRAS mutation analysis	KRAS	colorectal, non-small cell lung cancer
Enzymes and modulators	Prostate-specific antigen	PSA	prostate
Enzymes and modulators	Lactate Dehydrogenase A	LDHA	germ cell tumors, gastric
Enzymes and modulators	Lactate Dehydrogenase B	LDHB	germ cell tumors, gastric
Enzymes and modulators	Lactate Dehydrogenase C	LDHC	germ cell tumors, gastric
Enzymes and modulators	Neuron specific enolase (NSE)	ENO2	lung
Enzymes and modulators	Nuclear matrix protein 22 (NMP22)	NUMA1	bladder
Enzymes and modulators	plasminogen activator inhibitor (PAI-1)	SERPINE1	breast
Enzymes and modulators	SCC	SERPINB3	esopahgeal, lung, ovarian, squamous cell carcinoma
Enzymes and modulators	SCC	SERPINB4	esopahgeal, lung, ovarian, squamous cell carcinoma
Enzymes and modulators	Urokinase plasminogen activator (uPA)	PLAU	breast
Serum and tissue proteins	Apolipoprotein A1	APOA1	ovarian
Serum and tissue proteins	Beta-2-microglobulin	B2M	multiple myeloma, chronic lymphocytic leukemia, lymphoma
Serum and tissue proteins	Cytokeratin fragments 21-1 (Cyfra 21-1)	KRT19	breast, lung
Serum and tissue proteins	WAP Four-Disulfide Core Domain 2 (WFDC2)	WAP5	ovarian
Serum and tissue proteins	Ferritin	FTL, FTH1	liver
Serum and tissue proteins	Fibrinogen	-	bladder
Serum and tissue proteins	Fibrin D-Dimer	-	bladder
Serum and tissue proteins	S100	S100A1	malignant melanome
Serum and tissue proteins	Tissue polypeptide antigen (TPA)	-	lung
Serum and tissue proteins	Thyroglobulin	TG	thyroid
Cancer stem cells	Aldehyde dehydrogenase	ALDH1A1	cancer stem cells, breast, colon, lung, melanoma, pancreatic, prostate
Cancer stem cells	CD20	MS4A1	Cancer stem cells, Non-Hodgkin lymphoma, melanoma
Cancer stem cells	CD24	CD24	Cancer stem cells, colon cancer
Cancer stem cells	CD44	CD44	Cancer stem cells, breast, colon, liver, ovarian, pancreatic, prostate
Cancer stem cells	Nestin	NES	Cancer stem cells, glioma, pancreatic