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解密“滴血测癌”:监测患癌风险 不能“包打天下”

2017-05-08 10:52:32   

那么,从实验室移入生产线的试剂盒是什么样的产品呢?“将血滴到试剂盒里,两个小时后,就可以显示出数值,与该数值相对应,就可以判断癌症的风险值。”罗永章说,“其中用到的血其实比一滴还要少,一滴血大约50微升,我们仅仅需要一滴血的二十分之一,即2.5微升就足够了”。

需要强调的是,究竟是不是癌症,不是试剂盒说了算,而是病理学诊断说了算。并不是肿瘤标志物高了,就一定是癌症,也无法靠一种血液标志物百分百地诊断肿瘤。而且,无论是哪种肿瘤标志物,都不能妄想靠其测出得了哪种癌症。“肿瘤在不停地突变着,它的异质性决定了,不可能找到一个标志物专门针对某种肿瘤。”罗永章说。

那么,清华大学的成果究竟有何意义?付彦表示,该项成果给医生和患者提供了比现有肿瘤标志物更好的新工具,可以及早监测患癌的风险。此外,它可用于癌症患者的病情监测和治疗效果评价。

癌症患者在治疗过程中,血浆热休克蛋白90α的浓度会随着病情波动。例如,当治疗无效、病情加重时,其浓度升高;当肿瘤缩小、病情缓解时,浓度会降低;当病情稳定、肿瘤体积无显著变化时,浓度保持相对恒定。这些结果可以帮助临床医生来判断患者的疗效,帮助判断患者是否有复发,其临床意义是非常明确的。

目前,该试剂盒产品已经获得了13个省的物价批准,并已向近百家医院提交了入院申请,希望能尽快获得较大范围的推广。“在推广中还是遇到很多困难的,因为热休克蛋白90α试剂盒是新产品,得到认知和认可需要一个过程。而且,该产品还没有进入医保范围,患者在医院检测热休克蛋白90α不能享受医保。另外,新产品进入各地区的医院也需要有审批、试用和验证的环节,也需要一定的时间。”付彦说。

  “滴血测癌”不能“包打天下”

自从“滴血测癌”的提法出现,不少人将其理解为:只需要一滴血,就能知道自己是不是得了癌症,得了什么癌症。其实,这是对“滴血测癌”的误读。

“可测癌症和百分之百诊断癌症是两码事,可测并没有说百分之百确诊。事实上,当今没有任何一个检测手段,包括其他的肿瘤标志物,都不能直接用于癌症确诊,B超、核磁和CT等影像学检测也不能。目前,只有病理检测是金标准,但也存在一定的误差率。”罗永章强调。

罗永章认为,公众应该正确理解肿瘤标志物的意义,“肿瘤标志物最大的好处是快速、方便、便宜,可能筛查出许多危险人群。其最大的用途是早期筛查,目前没有别的方法可以替代它。除此之外就是疗效跟踪,这个特别有价值,对医生个体化用药很重要”。

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