Gülnur TOKUÇ, Sedat ÖKTEM, Özlem KETENCİ

Pediatrik onkolojide tümör belirteçlerinin klinikteki yeri

Tümör belirteçleri onkolojide gerek tanı, gerek prognoz ve gerekse izlemde sıklıkla kullanılır. Erişkinde kullanım alanları oldukça geniş olmasına karşın pediatride kullanılabildikleri tümör tipleri sınırlı olup, özgüllük ve duyarlılıkları da düşüktür. Bu derleme, pediatrik onkolojide klinik olarak kullanımı uygun ve anlamlı olan tümör belirteçlerini güncel bilgiler ışığında vurgulayarak gereksiz tetkiklerin ya da yanlış yorumların yapılmasını engellemek amacıyla yapılmıştır.

Anahtar Kelimeler:

Pediatri, Tümör belirteci, biyolojik, Tıbbi onkoloji

Use of tumour markers in clinical pediatric oncology

Tumour markers are used frequently in diagnosis, prognostic evaluation and follow up in oncology. They are used widely in adults but their use is limited and their specificity and sensitivity are low in pediatric tumour types. This rewiew is planned to determine the tumour markers that are useful and meaningful in pediatric oncology and to avoid unnecessary tests and wrong interpretations.

Keywords:

Pediatrics, Tumor Markers, Biological, Medical Oncology,

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1.Kellie SJ. Serum markers in tumor diagnosis and treatment. In: Pinkerton CR and Plowman PN, eds. Paediatric Oncology. 2nd ed. Chapman&Hall Medical, 1997: 189-219.
2.Perkins GL, Slater ED, Sanders GK, Prichard JG. Serum tumor markers. Am Fam Physician 2003; 68.: 1075-82.
3.Labdenne P, Heikinheimo M. Clinical use of tumor markers in childhood malignancies. Ann Med 2002; 34: 316-23.
4.Massacesi C, Rocchi MB, Marcucci F, Pilone A, Galeazzi M, Bonsignori M. Serum tumor markers may precede instrumental response to chemotherapy in patients with metastatic cancer. Int J Biol Markers. 2003; 18: 295-300.
5.Rye PD, Nustad K, Stigbrand T. Tumor marker workshop. Tumour Biol 2003; 24: 165-71.
6.Kashyap R, Jain A, Nalesnik M, et al. Clinical significance of elevated alpha-fetoprotein in adults and children. Dig Dis Sci 2001; 46: 1709-13.
7.Sayar D, Yaniv I, Goshen Y, Cohen IJ. Treatment of alpha-fetoprotein secreting hepatoblastoma by response of serum alpha-fetoprotein levels: a new concept. Pediatr Hematol Oncol 2001; 18: 509-18.
8.Abbasoglu L, Gun F, Tansu Salman F, et al. Hepatoblastoma in children. Acta Chir Belg 2004; 104: 318-21.
9.Veeramachaneni R, Herrera GA, Turbat-Herrera EA. Hepatoblastoma in a 15-month-old male: cytomorphology, electron microscopy, and differential diagnosis. Ultrastruct Pathol 2003; 27: 369-73.
10.Tsai JF, Jeng JE, Chuang LY, et al. Serum insulin-like growth factor-II.and alpha-fetoprotein as tumor markers of hepatocellular carcinoma. Tumour Biol 2003; 24: 291-8.
11.Mc Intire KR, Waldmann TA, Moertel CG, Go VLW. Serum. a-fetoprotein in patients with neoplasms of the gastrointestinal tract. Cancer Res 1975; 35: 991-6.
12.Bloomer JR, Waldmann TA, Mclntire KR, Klatskin G. a Fetoprotein in non-neoplastic hepatic disorders. J Am Med Assoc 1975; 233: 38-41.
13.Mizejewski GJ. Levels of alpha-fetoprotein during pregnancy and early infancy in normal and disease states. Obstet Gynecol Surv 2003; 58: 804-26.
14.Hu KQ, Kyulo NL, Lim N, et al. Clinical significance of elevated alpha-fetoprotein (AFP) in patients with cronic hepatitis C, but not hepatocellular carcinoma. Am J Gastroenterol 2004; 99: 860-5.
15.Mann JR, Lakin GE, Leonard JC, et al. Clinical applications of serum carcinoembryonic antigen and alpha-fetoprotein levels in children with solid tumors. Arch Dis Child 1978; 53: 366-74.
16.Melia WM, Johnson PJ, Carter S, et al. Plasma carcinoembryonic antigen in the diagnosis and management of patients with hepatocellular carcinoma. Cancer 1981; 48: 1004-8.
17.Molina R, Filella X, Auge JM, et al. Tumor markers (CEA, CA 125, CYFRA 21-1, SCC and NSE) in patients with non-small cell lung cancer as an aid in histological diagnosis and prognosis. Comparison with the main clinical and pathological prognostic factors. Tumour Biol 2003; 24: 209-18.
18.Berthold F, Hunnemann DH, Harms D, et al. Serum vanill-ymandelic acid/homovanillic acid contributes to prognosis estimation in patients with localised but not with metastatic neuroblastoma. Eur J Cancer 1992; 28: 1950-4.
19.Hervas Benito I, Rivas Sanchez A, Bello Arques P, et al.Value of 123I-MIBG scanning, neuron-specific enolase and serum ferritin in the diagnosis and follow-up of patients with neuroblastoma. Rev Esp Med Nucl 2001; 20: 369-76.
20.Cooper EH, Pritchard J, Bailey CC, Ninane J. Serum neuron-specific enolase in children's cancer. Br J Cancer 1987; 56: 65-7.
21.Martinez Ibanez Y, Abad P, Gallego S, et al. Neuroblastoma: biological markers, surgery, and clinical course. Cir Pediatr. 2000; 13: 47-53.
22.Pillon M, Di Tullio MT, Garaventa A, et al. Long-term results of the first Italian Association of Pediatric Hematology and Oncology protocol for the treatment of pediatric B-cell non-Hodg-kin lymphoma (AIEOP LNH92). Cancer 2004; 101: 385-94.
23.Bacci G, Forni C, Longhi A, et al. Long-term outcome for patients with non-metastatic Ewing's sarcoma treated with adjuvant and neoadjuvant chemotherapies. 402 patients treated at Riz-zoli between 1972 and 1992. Eur J Cancer. 2004; 40: 73-83.
24.Casadei R, Magnani M, Biagini R, Mercuri M. Prognostic factors in Ewing's sarcoma of the foot. Clin Orthop. 2004; 420: 230-8.
25.Belhaj R, Boussen H, Ghanem A, et al. Bioclinical correlations in bony metastases. Results of a prospective study. 60 cases. Tunis Med 2002; 80:691-5.
26.Takahashi H, Fujita S, Shibata Y, Yamaguchi A. Adenomatoid odontogenic tumour: immunohistochemical demonstration of transferrin, ferritin and alpha-one-antitrypsin. J Oral Pathol Med 2001; 30: 237-44.
27.Schneider DT, Calaminus G, Gobel U. Diagnostic value of alpha 1 -fetoprotein and beta-human chorionic gonadotropin in infancy and childhood. Pediatr Hematol Oncol 2001; 18: 11-26.
28.von Eyben FE. Laboratory markers and germ cell tumors. Crit Rev Clin Lab Sci 2003; 40: 377-427.
29.Roy N, Blurton DJ, Azakie A, Karl TR. Immature intraperi-cardial teratoma in a newborn with elevated alpha-fetoprotein. Ann Thorac Surg. 2004; 78: E6-8.
30.Isaac H Jr. Perinatal (fetal and neonatal) germ cell tumors. J Pediatr Surg 2004; 39: 1003-13.
31.Schineider BP, Keşler KA, Brooks JA, Yiannoutsos C, Ein-horn LH. Outcome of patients with residual germ cell or non-germ cell malignancy after resection of primary mediastinal non-seminomatous germ cell cancer. J Clin Oncol 2004; 22: 1195-2000.
32.Tangkijvanich P, Anukulkarnkusol N, Suwangool P, et al.Clinical characteristics and prognosis of hepatocellular carcinoma: analysis based on serum alpha-fetoprotein levels. J Clin Gastroenterol. 2000; 31: 302-8.
33.Mok TS, Yu SC, Lee C, et al. False-negative rate of abdominal sonography for detecting hepatocellular carcinoma in patients with hepatitis and elevated serum {alpha[-Fetoprotein Levels. Am J Roentgenol 2004; 183: 453-8.
34.Otto S. The role of tumor markers in the diagnosis and follow-up liver tumor. Orv Hetil 2004; 145: 385-7.
35.Smith AD, Dunk AA, Tuttle-Newhall JE, Trotter JF. Hepatocellular carcinoma. Lancet 2004; 363: 898-9.
36.Lenders JW, Pacak K, Walther MM, et al. Biochemical diagnosis of pheochromocytoma: which test is best? JAMA 2002; 287: 1427-34.
37.Bien E, Balcerska A, Ciesielski D. Does beta-2 microglobulin measurement play role in diagnostics of childhood malignancies? Wiad Lek. 2004; 57: 8-11.
38.Montalban C, Garcia JF, Abraira Y, et al. Influence of biologic markers on the outcome of Hodgkin's lymphoma: a study by the Spanish Hodgkin's Lymphoma Study Group. J Clin Oncol. 2004; 22: 1664-73.