Abstract | Tumorski markeri su razne biološke tvari koje nam daju informacije vezane uz tumor i koriste se u dijagnostici, određivanju stadija tumora, prognozi, nadzoru tumora tijekom i nakon liječenja te služe detekciji povrata bolesti. U urologiji se koristi veliki broj biomarkera.
Prostata specifični antigen ili PSA je najviše korišten tumorski marker u urologiji ali i u cjelokupnoj medicini. Zbog osjetljivosti testa neki od tumora mogu proći nezapaženi, a u isto vrijeme svaki porast PSA nije nužno znak karcinoma i može dovesti do izvođenja nepotrebnih biopsija. Kako bi se poboljšala osjetljivost i specifičnost, te izbjegla ograničenja vezana uz ovaj test razvijaju se novi markeri kao što su: brzina povišenja PSA, f/t PSA, gustoća PSA, PHI score, IsoPSA, 4K score i PCA3. Kod karcinoma mokraćnog mjehura mogu se koristiti urinski biomarkeri poput Urovision, NMP22, BTA, te markeri koji koriste genetski materijal kao što su Cx Bladder i AssureMDx. U karcinomu bubrežnih stanica tumorski markeri još nisu potvrđeni za kliničku uporabu, no postoji nekolicina serumskih i urinskih markera. U tumoru testisa rutinski se koriste tri biomarkera: AFP, hCG i LDH. Oni se mogu naći u povišenim vrijednostima zajedno ili zasebno, i tako upućuju na postojeći mogući tumor i njegovu vrstu. Iako su tumorski markeri zastupljeni u kliničkoj primjeni ima mjesta za napredak u pogledu već postojećih markera i povećanju njihove specifičnosti i osjetljivosti i razvoju novih biljega koji bi dodatno povećali učinkovitost |
Abstract (english) | Tumor markers are various biological substances that give us information related to the tumor and are used in diagnostics, staging, prognosis, tumor monitoring during and after treatment and serve to detect disease recurrence. A large number of biomarkers are used in urology.
Prostate specific antigen or PSA is the most used tumor marker in urology and in medicine as a whole. Due to the sensitivity of the test, some tumors may go unnoticed, and at the same time, increase in PSA is not necessarily a sign of cancer and may lead to unnecessary biopsies. In order to improve the sensitivity and specificity, and to avoid the limitations related to this test, new markers are being developed such as: PSA rise rate, f/t PSA, PSA density, PHI score, IsoPSA, 4K score and PCA3. In bladder cancer, urinary biomarkers such as Urovision, NMP22, BTA, and markers using genetic material such as Cx Bladder and AssureMDx can be used. In renal cell carcinoma, tumor markers have not yet been confirmed for clinical use, but there are several serum and urine markers. Three biomarkers are routinely used in testicular tumors: AFP, hCG and LDH. They can be found in elevated values together or separately, and thus indicate the presence of a possible tumor and its type. Although tumor markers are represented in clinical application, there is room for progress in terms of already existing markers and increasing their specificity and sensitivity and developing new markers that would further increase efficiency. |