use of tumor markers in testicular, prostate, colorectal, breast, and ...
use of tumor markers in testicular, prostate, colorectal, breast, and ...
use of tumor markers in testicular, prostate, colorectal, breast, and ...
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4 Use <strong>of</strong> Tumor Markers <strong>in</strong> Testicular, Prostate, Colorectal, Breast, <strong>and</strong> Ovarian Cancers<br />
Table 1. Currently Available Serum <strong>and</strong> Tissue Markers for Testicular Tumors<br />
Marker Proposed Use Phase <strong>of</strong> Development Level <strong>of</strong> Evidence Reference<br />
Established serum <strong>markers</strong><br />
AFP Diagnosis Generally available II (4, 65, 73, 89)<br />
Prognosis/stag<strong>in</strong>g I<br />
Monitor<strong>in</strong>g/surveillance II<br />
hCG Diagnosis Generally available II (4, 89, 103)<br />
Prognosis/stag<strong>in</strong>g I<br />
Monitor<strong>in</strong>g/surveillance II<br />
LDH Prognosis/stag<strong>in</strong>g Generally available I (63, 109)<br />
Potentially <strong>use</strong>ful experimental serum <strong>markers</strong><br />
hCGb Diagnosis Experimental IV (96, 103)<br />
Monitor<strong>in</strong>g<br />
LD-1 Diagnosis Experimental IV (109)<br />
Risk stratification<br />
PLAP Diagnosis Experimental IV (111, 112)<br />
NSE Diagnosis Experimental IV (116, 117)<br />
Established tissue <strong>markers</strong><br />
PLAP Histological typ<strong>in</strong>g<br />
ITGCNU<br />
c-KIT, stem cell<br />
factor rec.<br />
Typ<strong>in</strong>g <strong>of</strong> sem<strong>in</strong>oma<br />
<strong>and</strong> ITGCNU<br />
Antibodies for<br />
immunohistochemistry<br />
generally available<br />
Antibodies for<br />
immunohistochemistry available<br />
CD30 Embryonal carc<strong>in</strong>oma Antibodies for<br />
immunohistochemistry<br />
generally available<br />
AFP Typ<strong>in</strong>g <strong>of</strong> yolk sac<br />
<strong>tumor</strong>s <strong>and</strong> embryonal<br />
carc<strong>in</strong>oma<br />
hCG Typ<strong>in</strong>g <strong>of</strong> sem<strong>in</strong>oma<br />
<strong>and</strong> choriocarc<strong>in</strong>oma<br />
Amplification<br />
<strong>of</strong> 12p<br />
Vascular<br />
<strong>in</strong>vasion<br />
Established tissue <strong>markers</strong><br />
OCT3/4,<br />
POUF1<br />
Diagnosis <strong>of</strong> extragonadal<br />
<strong>tumor</strong>s<br />
Antibodies for<br />
immunohistochemistry<br />
generally available<br />
Antibodies for<br />
immunohistochemistry<br />
generally available<br />
II (24)<br />
II (28)<br />
IV (60, 519)<br />
II (24)<br />
II (24)<br />
Limited availability II (107, 108)<br />
Risk stratification Limited availability II (54)<br />
Risk stratification Experimental IV (58)<br />
Abbreviations: AFP, -fetoprote<strong>in</strong>; hCG, human chorionic gonadotrop<strong>in</strong>; hCG, free subunit <strong>of</strong> human chorionic gonadotrop<strong>in</strong>; LDH,<br />
lactic dehydrogenase; NSE, neuron specific enolase; NSGCT, nonsem<strong>in</strong>omatous germ cell <strong>tumor</strong>s; PLAP, placental (germ cell) alkal<strong>in</strong>e<br />
phosphatise; LOE, level <strong>of</strong> evidence (120).<br />
NOTE. Level 1, evidence from a s<strong>in</strong>gle, high-powered, prospective, controlled study that is specifically designed to test the marker, or<br />
evidence from a meta-analysis, pooled analysis or overview <strong>of</strong> level II or III studies; level II, evidence from a study <strong>in</strong> which marker<br />
data are determ<strong>in</strong>ed <strong>in</strong> relationship to prospective therapeutic trial that is performed to test therapeutic hypothesis but not specifically<br />
designed to test marker utility; level III, evidence from large prospective studies; level IV, evidence from small retrospective studies;<br />
level V, evidence from small pilot studies.
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