CHINESE JOURNAL OF MEDICINAL GUIDE >
Clinical Scenarios and Key Points of Clinical Evaluation for Biomarker Detection in Cancer Screening
Received date: 2025-06-30
Revised date: 2025-09-18
Accepted date: 2025-12-24
Online published: 2025-12-24
Cancer poses a significant public health issue that seriously threatens the lives and health of Chinese people. Cancer prevention and control is an important part of the “Healthy China Initiative”. Cancer screening serves as a vital tool for cancer prevention and control. With advancements in molecular biology, research on novel biomarkers for cancer screening has deepened, and these biomarkers are increasingly being applied in clinical practice. Compared to traditional screening methods such as ultrasound, CT, and endoscopy, biomarker-based approaches offer enhanced compliance and accessibility in cancer screening. This article summarizes the main clinical scenarios and clinical significance of biomarker detection in cancer screening, including direct application in the screening of cervical cancer, colorectal cancer, gastric cancer, prostate cancer, etc., the triage of positive screening results and the exploration in multiple cancer detection, and also, the article provides a detailed analysis of the key aspects of clinical evaluation for in vitro diagnostic reagents used in cancer screening, such as the reasonable determination of indications and applicable populations, the evaluation of sensitivity and specificity, the analysis of clinical benefits and risks, and the focus points of multiple cancer detection. This article aims to provide references for the design and development, clinical trial design, and technical review of related products.
Jingyun He
.
Clinical Scenarios and Key Points of Clinical
Evaluation for Biomarker Detection in Cancer Screening
[1] Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022[J].J Natl Cancer Cent, 2024,4(1):47-53.
[2] 陈茹,魏文强.《2022年中国癌症发病和死亡报告》解读[J].中国实用外科杂志,2025,45(2):174-180.
[3] Zheng R, Zhang S, Zeng H, et al. Cancer incidence and mortality in China, 2016[J].J Natl Cancer Cent, 2022,2(1):1-9.
[4] Lin JS, Perdue LA, Henrikson NB,et al. Screening for colorectal cancer updated evidence report and systematic review for the US preventive services task force[J].JAMA, 2021,325(19):1978-1998.
[5] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019[J].CA Cancer J Clin, 2019 ,69(1):7-34.
[6] 赫捷,李霓,陈万青,等.中国肺癌筛查与早诊早治指南(2021,北京)[J].中国肿瘤,2021,30(2):81-111.
[7] U.S.FDA. Summary of Safety and Effectiveness[EB/OL].(2024-05-14)[2025-06-18].https://www.accessdata.fda.gov/cdrh_docs/pdf16/P160037S017B.pdf.
[8] 李静然,吴瑞芳,魏丽惠,等.阴道自取样高危型人乳头瘤病毒检测用于子宫颈癌筛查的中国专家共识[J].中国妇产科临床杂志,2024,25(6):563-568.
[9] Shaukat A, Mongin SJ, Geisser MS, et al. Long-term mortality after screening for colorectal cancer[J]. N Engl J Med, 2013,369(12): 1106-14.
[10] U.S. FDA. Summary of Safety and Effectiveness[EB/OL].(2014-08-11)[2025-06-18].https://www.accessdata.fda.gov/cdrh_docs/pdf13/P130017B.pdf.
[11] 国家药品监督管理局医疗器械技术审评中心.KRAS基因突变及BMP3/NDRG4基因甲基化和便隐血联合检测试剂盒(PCR荧光探针法-胶体金法)(CSZ2000050)[EB/OL].(2020-11-02)[2025-06-18]. https://www.cmde.org.cn//xwdt/shpbg/20201112105300335.html.
[12] U.S. FDA. Summary of Safety and Effectiveness[EB/OL].(2024-07-26)[2025-06-18].https://www.accessdata.fda.gov/cdrh_docs/pdf23/P230009B.pdf.
[13] Ma JL, Zhang L, Brown LM, et al. Fifteen-year effects of Helicobacter pylori, garlic, and vitamin treatments on gastric cancer incidence and mortality[J].J Natl Cancer Inst, 2012,104(6):488-492.
[14] Li WQ, Zhang JY, Ma JL, et al. Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial[J].BMJ, 2019,366:l5016.
[15] 赫捷,陈万青,李兆申,等.中国胃癌筛查与早诊早治指南(2022,北京)[J].中华肿瘤杂志,2022,44(7):634-666.
[16] 赫捷,陈万青,李霓,等.中国前列腺癌筛查与早诊早治指南(2022,北京)[J].中国肿瘤,2022,31(1):1-30.
[17] Grossman DC, Curry SJ, Owens DK, et al. Screening for prostate cancer: us preventive services task force recommendation statement[J]. JAMA, 2018,319(18):1901-1913.
[18] Schrag D, Beer TM, McDonnell CH, et al. Blood-based tests for multicancer early detection (PATHFINDER): a prospective cohort study[J]. Lancet, 2023,402(10409):1251-1260.
[19] 李明珠,李静然,李晓,等.中国子宫颈癌筛查指南(二)[J].肿瘤综合治疗电子杂志,2025,11(3):1-12.
[20] 国家药品监督管理局医疗器械技术审评中心. 高危型人乳头瘤病毒核酸检测试剂盒(荧光PCR法)(CSX2100396)[EB/OL].(2023-06-15)[2025-06-18].https://www.cmde.org.cn/xwdt/shpbg/20230627091007154.html.
[21] 国家药品监督管理局医疗器械技术审评中心.人ASTN1、DLX1、ITGA4、RXFP3、SOX17、ZNF671基因甲基化检测试剂盒(荧光PCR法)(CSZ1900359)[EB/OL].(2022-08-03)[2025-06-18].https://www.cmde.org.cn//xwdt/shpbg/20220901110621132.html.
[22] Krist AH, Davidson KW, Mangione CM, et al. Screening for lung cancer: US preventive services task force recommendation statement[J].JAMA, 2021,325(10):962-970.
[23] 詹思延主编.流行病学(第8版)[M].北京:人民卫生出版社,2017:120-139.
[24] Wilson JMG, Junger G. Principles and practice of screening for disease[M].World Health Organization,1968:26-27.
[25] 中华预防医学会妇女保健分会.子宫颈癌综合防控指南[M].北京:人民卫生出版社,2017.
[26] 陈万青,李霓,兰平,等.中国结直肠癌筛查与早诊早治指南(2020,北京)[J].中国肿瘤,2021,30(1):1-28.
[27] 赫捷,陈万青,李霓,等.中国女性乳腺癌筛查与早诊早治指南(2021,北京)[J].中国肿瘤,2021,30(3):161-191.
[28] 赫捷,陈万青,李兆申,等.中国食管癌筛查与早诊早治指南(2022,北京)[J].中国肿瘤,2022,31(6):401-436.
[29] 国家卫生健康委员会.原发性肝癌诊疗指南(2022年版)[J].浙江实用医学,2022,27(6):528-536.
[30] 国家药品监督管理局医疗器械技术审评中心.体外诊断试剂临床试验技术指导原则(2021年第72号)[EB/OL].(2021-09-27)[2025-06-18].https://www.cmde.org.cn//flfg/zdyz/zdyzwbk/20210929091646387.html.
[31] 国家药品监督管理局医疗器械技术审评中心.人乳头瘤病毒(HPV)核酸检测及基因分型试剂技术审查指导原则(2015年第93号)[EB/OL].(2015-04-05)[2025-08-18].https://www.cmde.org.cn//flfg/zdyz/zdyzwbk/20170405151300482.html.
[32] Pinsky PF. Principles of ccancer sscreening[J].Surg Clin North Am, 2015,95(5):953-966.
/
| 〈 |
|
〉 |