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2012 | 10 | 2 | 116-123
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Nowe markery w raku jajnika

Title variants
New markers in ovarian cancer
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Neoplastic markers represent high molecular weight substances produced both by neoplastic and healthy cells in response to a developing tumor. A marker may also involve any assayable substance in tumor tissue which manifests immunoreactivity distinct from that in normal tissues. Neoplastic markers serve in the detection of the disease, monitoring of treatment efficacy and in the detection of a relapse. In the case of ovarian cancer, the most recognizable marker involves CA-125, an elevated level of which is detected in around 80% serous carcinomas andwhich increases as the disease progresses. Early stages of ovarian carcinomas are detected by estimation of HE4 (human epididymis protein). The Risk of Malignancy Index (RMI algorithm) is based on the estimation of the CA-125 level, transvaginal ultrasound examination and condition of menopause. Other algorithms used in ovarian carcinoma include OVA-1, based also on CA-125 level, menopausal status and on four proteomic markers, and ROMA (Risk of Ovarian Malignancy Algorithm), based on CA-125 and HE4. Other markers of less pronounced importance for ovarian carcinoma include: • CA-19-9 (antigen of gastrointestinal carcinoma) – of particular use in carcinomas of gastrointestinal tract, including pancreatic carcinoma but also mucous ovarian carcinoma; • CEA (carcinoembryonic antigen) – a marker of alimentary tract carcinomas, including colorectal carcinoma, gastric carcinoma but also mucous ovarian carcinoma; • CA-15-3 (MUC1) – the recognized marker of breast carcinoma, the concentration of which increases in advanced stages of ovarian carcinoma; • YKL-40 (glycoprotein of human cartilage) – allowing detection of early stages of ovarian carcinoma and its relapses; • kisspeptin (KiSS-1) – associated with the inhibition of metastases in clarocellular ovarian carcinoma; • HIF-1α (hypoxia-inducible factor-1α) – similarly to clusterin, linked to resistance to chemotherapy; • E-cadherin, SDF-1 and metadherin linked to the development of metastases; • enzymatic markers COX-1 and in particular COX-2 correlate with the progress of the disease while an increased COX-2 level indicates resistance to chemotherapy.
Markery nowotworowe są wielkocząsteczkowymi substancjami wytwarzanymi w odpowiedzi na rozwijający się nowotwór zarówno przez komórki nowotworowe, jak i komórki zdrowe. Markerem może być także substancja oznaczona w tkance guza, która wykazuje inną immunoreaktywność niż w tkankach zdrowych. Markery nowotworowe służą do wykrycia choroby, monitorowania skuteczności leczenia, a także wykrycia wznowy. Najbardziej uznanym markerem dla raka jajnika jest CA-125, którego podwyższone stężenie występuje w około 80% raków surowiczych i wzrasta wraz z zaawansowaniem choroby. Do wykrycia wczesnych stadiów raka jajnika stosuje się HE4 (human epididymis protein). Na wartości stężenia CA-125, badaniu przezpochwowym i stanie menopauzalnym oparty jest algorytm RMI (Risk of Malignancy Index). Innymi algorytmami stosowanymi w raku jajnika są OVA-1 (oparty również na wartości CA-125, stanie menopauzalnym i czterech markerach proteomicznych) oraz ROMA (Risk of Ovarian Malignancy Algorithm), włączający do badania wartość CA-125 i HE4. Markerami mającymi mniejsze znaczenie w raku jajnika są: • CA-19-9 (gastrointestinal cancer antigen) – stosowany w rakach przewodu pokarmowego (w tym raku trzustki), ale również w raku śluzowym jajnika; • CEA (carcinoembryonic antigen) – marker dla raków przewodu pokarmowego, w tym raka jelita grubego i żołądka, ale też raka śluzowego jajnika; • CA-15-3 (MUC1) – uznany marker dla raka piersi, którego stężenie wzrasta w zaawansowanych stadiach raka jajnika; • YKL-40 (ludzka chrząstkowa glikoproteina) – wykrywająca wczesne stadia raka jajnika i jego wznowy; • kisspeptyna (KiSS-1) – związana z hamowaniem przerzutowania w jasnokomórkowym raku jajnika; • HIF-1α (hypoxia-inducible factor-1α) – związany z opornością na leczenie chemiczne, podobnie jak klusteryna; • E-kadheryna, SDF-1 (stromal-derived factor-1) i metadheryna – związane są z przerzutowaniem; • markery enzymatyczne COX-1 i COX-2 – korelują z progresją choroby, a wzrost stężenia COX-2 świadczy o oporności na chemioterapię.

Physical description
  • Klinika Perinatologii i Chorób Kobiecych, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu,
  • Klinika Onkologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
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