소화기암에서 암표식자의 조합에 의한 진단율상승에 관한 연구 = Improvement of Detectability in Alimentary Tract Cancers by Combination of Tumor Markers

다국어 초록 (Multilingual Abstract)

Attempts have been made to identify tumor-specific products in blood and urine that might serve as sensitive and specific markers of neoplastic growth. Recently, monoclonal antibody technology using the procedure of hybridization has been developed, and has given new hope for developing improved methods to define and quantify tumor markers. But, in recent studies with this new technique, the sensitivity and specificity of these antibodies in identifying patients with gastrointestinal carcinomas were not so superior to those of the conventional tumor markers. The serum levels of tumor markers (α-fetoprotein, CEA, ferritin, CA19-9, TPA, elastase) was examined by the radioimmunoassay in 65 patients with alimentary tract cancers (19cases of stomach cnacer, 23cases of hepatoma, 11cases of cholangiocarcinoma, and 12cases of pancreatic cancer), in 38 patients with corresponding benign conditions of alimentary tract (9cases of benign gastric ulecr, 18cases of liver cirrhosis, 7cases of cholangitis with gallstones, and 4cases of chronic pancreatitis) and in 8 normal persons, and the sensitivity and specificity of various combinations of the tumor markers in identifying the presence of these malignant conditions were compared with each other by the method of Receiver Operating Characteristic (ROC). The results were as follows: 1) The most excellent combinations were TPA×AFP for stomach cancer, AFP×ferritin×TPA or AFP×ferritin×TPA×elastase for hepatoma, TPA or TPA×CEA for cholangiocarcinoma and TPA×elastase, TPA×AFP or TPA×AFP for pancreatic cancer. 2) Any increase in unmber of the constituent above the foregoing combinations was of little benefit to the sensitivity and specificity of tumor markers in identifying the malignant conditions. In conclusion, this study suggests that the most excellent combinations of tumor markers for detecting the causes of alimentary tract were as mentioned-above and any increase in the number of the constituent was of little benefit.