Onkológia 4/2010

Utilisation of immunochemical methods and molecular genetics in monitoring patients with cervical cancer

Recognition of human papillomavirus (HPV) as the main cervical cancer ethiopathogenic agent has opened the door to molecular genetics in gynaecological practice. As the 20th century was called the century of antibiotics, the 21th century can be called as the century of vaccines. Developed countries have started with the prophylactic vaccination of adolescents. HPV DNA analysis was incorporated into the screening of cervical cancer. These are the areas of primary and secondary prevention. However, is molecular genetics – the identification of HPV DNA utilizable also for monitoring of patients after treatment? At present in the follow-up of these patients usually used examinations of tumor markers: squamocellular carcinoma antigen (SCCA), carcinoma antigen 125 (CA 125), cytokeratin fragment 21-1 (Cyfra 21-1). To a lesser extent carcinoembryonal antigen (CEA), tissue polypeptid antigen (TPA) is detected. The raising level of tumor markers is already a manifestation of an evolving process (progression, relapse). Effective management of oncologic disease, however, should be aimed at preventing its occurrence. We are getting to the area of tumor biology – molecular genetics. The clear determination of genetic prognostic markers should lead to more efficient care for patients with cervical cancer.

Keywords: cervical cancer, HPV DNA analysis, tumor markers, management after surgery, tumor biology.