Authors. María García Barcina*, Ana E. Martín Bueno, Luis Bujanda Fernández de Piérola, José Julio Hernández Hernández, Alberto Ortíz de Zárate Tercero, María José Suárez Torre, Cristian Amézaga Asensio, Alberto Loizate Totorikaguena.
* Contact address: Unidad de Genética, Hospital de Basurto, Avda. de Montevideo 18, 48013 Bilbao. E-mail: gbarcina@hbas.osakidetza.net
Sensitivity and specificity; Cohort studies; Mass screening; gastrointestinal neoplasms; lung neoplasms,; breast neoplasms, carcinoma, hepatocellular; ; Alpha-fetoproteins; CA-125 Antigen; CA-15-3 antigen; CA-19-9 antigen; Carcinoembryonic antigen; Tissue polypeptide antigen
CYFRA; Neuron specific enolase (NSE); Squamous cell carcinoma-related antigen (SCC)
Date: 2002
Pages: 170
References:
Language: spanish, english and basque abstracts
Legal number: Vi-457-02
Seric tumor markers are substances that can often be detected in higher-than normal amounts in the blood of some patients with certain types of cancer. They could be useful in the investigation and monitoring of neoplasic disease. Actually, there is so large number of studies and contradictory data that the question arises if tumor markers have a really proven role in the detection, diagnosis, staging, monitoring or prediction of response to treatment in these patients.
The aim of this study is to analyse the scientific evidence of the value in the diagnosis and prognosis of CA19.9 and CEA in colorectal cancer, AFP in hepatocellular carcinoma, CA15.3, CEA y TPA in breast cancer and CA125, CEA, CYFRA21.1, NSE and SCC in lung cancer.
Systematic review of the literature and synthesis of the evidence. Steps: a) localization of previous practice guidelines or systematic reviews. b) Evaluation of this studies with the tables of critical lecture supplied by AGREE and OSTEBA. c) Computerized search on PubMed (until june 2001) and Cochrane Data Base (number 3-2000). The articles selected, according to the criteria assigned by group consensus, comprised articles in english, french, italian or spanish. d) levels of evidence and guideline grades were rated by the criteria of Canadian Medical Association (1979) and American Society of Clinical Oncology (ASCO). e) Analyse and synthesis of the data.
3156 articles were localised and 464 were selected for the final analysis. The methodological value of the articles was not suitable, most of them were retrospective clinical series. There was not any tumor marker, among these analysed, that could isolated contribute to the diagnosis, prognosis or monitoring of the studied cancer.
Data are insufficient to recommend: a) the use of CA19.9 or CEA in the screening, diagnosis, prognosis, surveillance or monitoring after treatment of patients with colorectal cancer; b) the use of AFP in the early detection of HCC; c) the use of CA15.3, CEA or TPA in the screening, diagnosis, staging, prognosis or follow-up after treatment of patients with breast cancer; d) the use of CA125, CEA, CYFRA21.1, NSE or SCC in the diagnosis, prognosis, early detection of recidive or monitoring of the response to treatment of patients with lung cancer.