Abstract
'Current tumor markers are neither highly sensitive nor tumor specific.' A. L. PohP The hope of finding some unique meta- bolic products or unique components of malignant cells circulating in body fluids which can be measured is as old as mod- em biochemistry. The term 'tumor marker' for such an entity was coined by Morton K. Schwartz of the Sloan Ket- tering Institute. An effective tumor marker should be specific for malig- nancy, provide a minimum of false-posi- tives and false-negatives, indicate the extensiveness of the malignancy, and preferably diminish or disappear after effective therapy. At a recent International Conference held in Vienna under the auspices of the Society For Early Detection of Cancer, someone calculated that there were reports on almost 90 different tumor markers. Unfortunately, none of these putative tumor markers meet the above qualifications even partly. There are two major reasons for this. The most obvious is the pressing need for a scien- tist to get his work published in order to obtain funds. This makes it tempting for eager individuals to publish results pre- maturely, without establishing whether the results are statistically meaningful. For example, I recently read the follow- ing about a new tumor marker: '99% of normals had values ranging from 1 to 35'; numbers of individuals, means and stan- dard deviations were not reported (this was in an important journal of gynecol- ogy from a famous institution). I was appalled by the total lack of assessments of the significance of the scant data on which conclusions were drawn. About fifty years ago, my mentor for my gradu- ate studies was the distinguished bio- chemist, H. T. Clarke. Although he was a courteous English gentleman, he would have flayed me alive in front of my colleagues had I given a report with data like that.
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