Nanotchnology, Scnc and Applcatons 2011:4
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Bosnsors and arly cancr dtcton
or screening and diagnosis o prostate cancer. Studies haveshown that above-normal PSA levels correlate directly with prostate cancer. A normal level o PSA is 4.0 ng/mL. A studyconducted by Smith ound that roughly 30% o men with aPSA level between 4.1 and 9.9 ng/mL had prostate cancer.
In addition to prostate cancer, elevated PSA levels may alsoindicate benign prostatic hyperplasia, prostatitis (infamma-tion o the prostate), or smaller tumors that do not prove to beatal. Thus, PSA levels are not always indicative o malignanttumors, a act that has prompted considerable controversyabout the value o routine PSA screening or prostate cancer.Small tumors that are detected by PSA screening may inact grow so slowly that death rom the tumor would not be possible in a man’s lie span. Furthermore, treatment o these slow-growing tumors is costly and oten involves lie-changing surgeries that may not be necessary. However, ina study o 695 men with prostate cancer who were assigned to either radical prostatectomy or observation (watchulwaiting), it was shown that prostatectomy reduced morbidity,mortality, the risk o metastasis, and local progression morethan watchul waiting,
suggesting that treatment o any kind is more valuable than simple observation. Thus, despite thecontroversy surrounding PSA screening, it may be less harm-ul or a patient to receive unnecessary treatment or a benigncondition than to not be treated or a malignant tumor.Another issue with the PSA test is that alse positivesare common, and many men with elevated PSA levels donot have prostate cancer at all.
This tendency with PSAscreening is an area that biosensors can help by eliminatingsome o the ambiguity surrounding the common screeningmethods used today.
Cancr antgn 125
Elevated cancer antigen (CA) 125 is most commonlyassociated with ovarian cancer and is also linked to cancerso the uterus, cervix, pancreas, liver, colon, breast, lung,and digestive tract. Several nonpathological conditions suchas menstruation and pregnancy can also result in increased levels o CA 125.
CA 125 is elevated in 90% o womenwith advanced ovarian cancer and in 40% o patients withintra-abdominal malignancy. However, it should also benoted that in Stage 1 ovarian cancer, 50% o patients willhave normal CA 125 levels.
Other biomarkers that arelinked to ovarian cancer are germ cell in origin such ashuman chorionic gonadotrophin (HCG), alpha-etoprotein(AFP), and lactate dehydrogenase (LDH).
Elevated CA 125ollowing total abdominal hysterectomy or bilateral salpingo-oophorectomy, which may ollow rst-line chemotherapytreatment, is suggestive o disease recurrence or treatmentailure. In addition, increases in CA 125 have been used toidentiy the progression o benign cells to malignant cells.
Overall, CA 125 is a valuable biomarker not only or can-cer diagnosis, but also or various other aspects o cancer treatment and progression.
CA 15-3 is an important biomarker analyzed in breast cancer patients. Other biomarkers that are linked to breast cancer are carcinoembryonic antigen (CEA), BRCA1, BRCA2, and CA 27.29.
CA 15-3 is used clinically most oten to moni-tor patient therapy in cases o advanced breast cancer.In patients with breast cancer, it has been shown that CA 15-3concentrations increase by 10% in Stage I cancer, 20% inStage II, 40% in Stage III, and 75% in Stage IV breastcancer.
Tampellini and colleagues investigated the relation-ship between CA 15-3 levels and breast cancer and showed that individuals with values o
30 U/mL beore treatmentonset had signicantly higher survival times than individualswho had higher levels. The study also ound that higher CA 15-3 values correlated with extensive metastasis.
Another study determined that rising CA 15-3 values ater treatment can indicate disease recurrence.
At present,CA 15-3 levels are considered along with tumor size, cancer stage, and negative risk actors (ie, Her-2 and ER/PR status)in determining treatment protocols. Other conditions that cancause CA 15-3 levels to increase are endometriosis, pelvicinfammatory disease, hepatitis, pregnancy, and lactation.
Cancer-testis (CT) antigens are a unique class o cancer biomarker. They are highly expressed in many tumors, butnot in normal cells, except or germ cells o the testis. Thus,they have been heavily pursued as potential immunogenictargets or cancer immunotherapies (ie, cancer vaccines), and
Common bomarkrs utlzd for cancr dtcton
Type of cancerBiomarker
BrastBRCA1, BRCA2, CA 15-3, CA 125, CA 27.29, CeA,NY-BR-1, iNG-1, HeR2/NeU, eR/PRColonCeA, eGF, p53esophagalSCCLrAFP, CeALungCeA, CA 19-9, SCC, NSe, NY-eSO-1MlanomaTyrosnas, NY-eSO-1OaranCA 125, HCG, p53, CeA, CA 549, CASA, CA 19-9,CA 15-3, MCA, MOv-1, TAG72ProstatPSA