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Biomarkers for Detection of Intra-epithelial Neoplasia

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Pre-Invasive Disease: Pathogenesis and Clinical Management

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Abstract

Biological characteristics have been used for millennia to characterise and diagnose ailments and we now term these biomarkers. With the advent of the “omics” era the knowledge of the molecular events involved in carcinogenesis has increased greatly and this has been followed by the expectation that clinical practice could be revolutionised by novel molecular approaches. The National Institute of Health (NIH) has initiated a Biomarker workforce to clearly define biomarkers and the Early Detection Research Network Group offer guidelines for the development and validation of cancer biomarkers. The idea is that these more stringent guidelines will reduce the number of badly designed, underpowered biomarker studies so that quality data can be collected which will help bring biomarkers into clinical use. Although developed for invasive cancer these definitions and guidelines also apply to markers for intraepithelial neoplasia (IEN). The identification of these pre-malignant lesions may be central to reduction of cancer mortality since they are indolent and allow time for chemoprevention and/or treatment measures before cancer develops to an incurable stage. Biomarkers are needed to allow for detection of IENs and to predict which lesions are at highest risk of progression. The development and validation of cancer biomarkers is riddled with practical difficulties such as sample collection and identification of confounding factors and these are in many cases highly problematic in the case of IEN. Although a number of biomarkers are under evaluation for IEN, there are currently no biomarkers in clinical practice that were developed specifically for this purpose. Screening markers such as prostate serum albumin and faecal occult blood test do however also detect early cancers including a small proportion of IEN. There is a real clinical need for biomarkers in the field of preinvasive disease however it is likely that progress will only be made if strong collaborative links are forged between academia, industry and clinical practice.

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Acknowledgements

The authors are supported by the Medical Research Council, Cambridge Experimental Cancer Medicine Centre and the NIHR Cambridge Biomedical Research Centre.

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  1. Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, CB22 0XZ, UK

    Pierre Lao-Sirieix

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  1. Kareem M. Shariff
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Correspondence to Pierre Lao-Sirieix .

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  1. , MRC Cancer Cell Unit, Hutchison-MRC Research Centre, Hills Road, Cambridge, CB20XZ, United Kingdom

    Rebecca C. Fitzgerald

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Shariff, K.M., Lao-Sirieix, P. (2011). Biomarkers for Detection of Intra-epithelial Neoplasia. In: Fitzgerald, R. (eds) Pre-Invasive Disease: Pathogenesis and Clinical Management. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6694-0_9

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