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Tumormarker thorakaler Neoplasien

Welche Rolle spielen sie in der Klinik?

Tumor markers in lung cancer

What role do they play in clinical practice?

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Lungenkarzinome stellen 95–98% der primär pulmonalen malignen Tumoren dar und verursachen weltweit die meisten Todesfälle unter den Tumorerkrankungen. Ein klinisch sinnvoller Einsatz von Tumormarkern sollte zur Verbesserung der Lebensqualität und zu einem längeren Überleben für den Krebspatienten bei gleichzeitiger Verminderung der Krankheitskosten führen. Große randomisierte prospektive und retrospektive Studien wie auch Metaanalysen zur Evaluation der bisher eingesetzten Tumormarker zeigen ein eher ernüchterndes Ergebnis. Dennoch können in bestimmten Fällen Tumormarker ein wichtiges (differenzial)diagnostisches und prognostisches Kriterium sein und, zusätzlich zur morphologischen Diagnostik, wertvolle Hilfestellung bei der Stadieneinteilung, Therapie- und Verlaufskontrolle liefern. Die Bestimmung eines Tumormarkers ist aber grundsätzlich nur dann sinnvoll, wenn aus dem Ergebnis Konsequenzen für die weitere Behandlung/Betreuung des Patienten gezogen werden. Der Einsatz von CYFRA 21-1, CEA, NSE, ProGRP und SCCA als primäre Tumormarker beim Lungenkarzinom wird dargestellt und ihre klinische Relevanz im Zusammenhang mit nationalen und internationalen Empfehlungen diskutiert.

Abstract

Lung carcinomas account for 95–98% of primary pulmonary malignant tumors and are the most frequent cause of death from cancer worldwide. The appropriate use of tumor markers should lead to improved quality of life and to a longer survival for the cancer patient, with a concurrent decrease in healthcare costs. Randomized prospective and large retrospective studies as well as meta-analyses regarding the tumor markers used to date show rather sobering results when it comes to evidence-based outcomes. Still, tumor markers have considerable potential for differential diagnosis and prognosis, and, in addition to morphological diagnostics, they can deliver valuable assistance in staging, control of therapy efficacy, postoperative follow-up, and detection of recurrent disease. However, the use of tumor markers makes sense only if conclusions for the patient’s treatment and care are drawn from the results. The use of CYFRA 21-1, CEA, NSE, ProGRP, and SCCA as primary tumor markers in lung cancer is presented, and their clinical relevance is discussed with regard to national and international recommendations and guidelines.

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  1. Medizinisches Labor Wahl, Paulmannshöher Str. 14, 58515, Lüdenscheid, Deutschland

    H.G. Wahl

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Wahl, H. Tumormarker thorakaler Neoplasien. Pneumologe 6, 224–232 (2009). https://doi.org/10.1007/s10405-008-0303-z

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