Due to the increasing health awareness of the whole people, regular physical examination has become a necessary part of life, and tumor markers have gradually entered the public eye. However, in the face of professional report data, many people are confused by a question - "Are you getting involved with a tumor?" So, let's talk about tumor markers.
01. What are tumor markers?
Tumor markers are specific substances that are present in proteins, nucleic acids, sugars, and extracellular vesicles in blood, body fluids, cells, or tissues that are present in low or absent biomarkers in normal cells. Popularly understood, it is the traces of healthy cells after tumor cells invade the human body, and these""Traces" are tumor markers.
02. Tumor markers are not suitable for everyone.
Screening for tumor markers is a pathway for early detection of asymptomatic microfocal tumors, but it is only a means of adjunctive testing. The following are the basic steps for screening for tumor markers:
early detection of tumors;
Tumor screening and screening;
diagnosis, differential diagnosis and staging of tumors;
Monitoring of the efficacy of surgery, chemotherapy and radiotherapy in cancer patients;
Indicators of tumors**;
prognosis of tumors;
Look for the primary lesion of the metastatic tumor that is unknown.
03. For the following 6 conditions, it is recommended to screen for tumor markers:
Healthy people over 40 years of age;
Those who have a "tumor signal" in the body;
Specific Occupational Exposures;
Long-term chronic medical history such as hepatitis B, gastric ulcer, enteritis, preference for high-temperature diet, irritable mood;
People who have been exposed to carcinogens for a long time;
People in areas with a high incidence of cancer or a family history of cancer.
04. Is a high tumor marker cancer?
It is necessary to interpret it correctly:
suggests the possibility of the presence of a tumor, but it is only possible;
To evaluate the effect of tumor **, look at the change in numbers;
Monitor the tumor for ** and recheck the blood regularly. A positive tumor marker does not necessarily have a tumor, and to confirm the diagnosis, further imaging examinations such as CT, color ultrasound, and MRI or laparoscopy, exfoliative cytology, and pathological biopsy examinations are required.
When there is a change in tumor markers, it can be properly adjusted and rested under the guidance of a physician, and re-examination can be carried out after one or two months. In general, it is clinically significant only when it rises or falls to 25% of the reference range. There are false positives and false negatives in tumor marker tests, and the false positive rate is higher because they are screening indicators. An elevation of one test is not enough to illustrate the problem, and retesting and regular retesting are still required, and the increase is greater when the increase is at the upper limit of the reference range of 50.
Patients with abnormal tumor markers can only be regarded as high-risk groups, and abnormal diagnosis of tumor markers does not mean that the tumor has been diagnosed. However, because some tumors do not secrete related proteins, the normal diagnosis of tumor markers does not exclude the possibility of tumor existence.
The following are the cases in which non-cancerous factors cause abnormalities in the diagnosis of tumor markers:
increased CA125 may occur during menstruation, pelvic inflammatory disease, and pregnancy;
Biliary obstruction, gastritis, inflammatory bowel disease, and smoking may increase CEA (33% of smokers have elevated CEA);
Ca19-9 can be elevated in patients with pancreatitis, biliary tract disease, and cirrhosis. Therefore, it is difficult to diagnose cancer based on a single elevated swelling mark, let alone determine which type of cancer it is, and further examination is needed. Combination of multiple tumor markers can improve diagnostic sensitivity. Therefore, special attention needs to be paid to the following situations: The increase of tumor marker indicators in a single examination is very obvious, and it is several times higher than the reference range;
After repeated re-examinations, the index continued to rise;
Have a family history of cancer, especially in relatives within three generations, who are found to have elevated tumor markers;
A number of tumor markers were elevated.
If this happens, it is advisable to refine further testing under the guidance of a doctor. If the tumor marker test is negative for patients with high suspicion or obvious symptoms, the influence of in vivo factors and in vitro factors in the tumor marker determination should be considered, and it is recommended to re-test or combine the detection of tumor markers, and combine with other imaging examinations, or even genetic testing, which should be done for specific conditions and specific analysis. Rational judgment, no panic, no arbitrariness, correct understanding, scientific response.
Summary: Indicators are only clues, not for diagnosing tumors; If the index is high, it needs to be examined, and imaging pathology is very important; A single indicator needs to be investigated, and multiple references are more valuable; Metrics are not peer-to-peer, just reminders to pay more attention.
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