Does an elevated tumor marker mean cancer? Abnormal tumor markers, how to deal with it? Which tumor markers should be paid special attention to, and which ones should not be raised too much stress?
What are tumor markers
Tumor markers refer to substances characteristically present in malignant tumor cells or abnormally produced by malignant tumor cells, which can reflect the occurrence and development of tumors. By detecting the content of tumor markers in the blood, the condition and treatment effect of malignant tumors such as liver cancer, lung cancer and gastric cancer can be judged.
The commonly used humoral tumor markers mainly include carcinoembryonic antigen, carbohydrate antigen 19-9, carbohydrate antigen 12-5, Carbohydrate antigen 15-3, alpha-fetoprotein, squamous cell carcinoma antigen, etc.
Does elevated tumor markers mean cancer?
High tumor markers are not necessarily cancer. With the development of science and technology and people’s attention to their own health, more and more people begin to add tumor markers to their physical examinations. Individual indicators are light. The increase of the degree does not necessarily mean that it must be cancer, but it only needs to arouse our great attention.
Common tumor markers are:
1. Alpha-fetoprotein: It is a common check item for primary liver cancer in the physical examination. If it increases significantly, it is very likely to be cancer, and it is very likely to be liver cancer. However, some patients with hepatitis and cirrhosis may have increased alpha-fetoprotein. Increased fetoprotein is a physiological phenomenon, so mild elevation of alpha-fetoprotein should not be too stressful.
Recommended tests: Contrast-enhanced liver ultrasound, or liver tumor-specific magnetic resonance imaging, or contrast-enhanced computed tomography (CT) of the upper abdomen ), needle biopsy if necessary.
2. Carcinoembryonic Antigen: Mainly for colorectal cancer, lung cancer, pancreatic cancer, gastric cancer, liver cancer, breast cancer, etc., but some benign tumors, such as inflammatory colon polyps, ulcerative colitis, pancreatitis, etc. It can also be seen that this index is slightly increased, but the degree of increase is far lower than that of malignant tumors.
Recommended examinations: Gastrointestinal endoscopy, chest CT, abdominal CT.
3. Carbohydrates Antigen 125 (CA125): Higher specificity. Elevated in gynecological tumors (ovarian cancer, endometrial cancer), but also in bile duct cancer, pancreatic cancer, breast cancer, lung cancer, etc. Note: It may also increase during pregnancy, menstruation, pelvic infection, tuberculosis infection, and chronic inflammation of the hepatobiliary and pancreas.
Recommended examinations: Uterine appendix ultrasound, whole abdomen enhanced CT, tuberculin test (PPD).
4. Prostate-specific antigen (PSA) ): higher specificity. Elevated can be seen in prostate cancer, but also in other urinary system tumors. Note: Rarely, benign prostatic hyperplasia or prostatitis can also be elevated.
Recommended tests: Transrectal prostate ultrasound, or prostate magnetic resonance, if necessary, biopsy.
5, Carbohydrate antigen 19-9 (CA19-9): Higher specificity. Elevated can be seen in pancreatic cancer, but also in bile duct cancer, gastrointestinal cancer and so on. Note: Very rarely, chronic inflammation of the hepatobiliary and pancreas can also cause mild elevations.
Recommended tests: Contrast-enhanced CT or ultrasound of the abdomen. Note: Abdominal ultrasound is easy to miss small tumors.
6, Carbohydrate antigen 15-3 (CA15-3): Low specificity. Elevated in advanced breast cancer. Note: If only this item is slightly elevated, there is no need to be nervous, but this indicator needs to be rechecked several times.
Recommended examination: Breast ultrasound. If there is a history of breast cancer, whole body CT should be done to evaluate whether there is metastasis.
7, Carbohydrate antigen 72-4 (CA72-4): Low specificity. Elevated in gastrointestinal tumors. Note: If only this item is slightly elevated, it generally does not suggest a tumor.
Recommended tests: Abdominal ultrasound or abdominal CT with contrast.
It can be seen that elevated tumor markers does not necessarily mean cancer. If the tumor markers are only slightly elevated, and the reference significance beyond the normal value is not much, then this possibility is relatively low. Of course, regular review is required. , if the detected value continues to increase and is more than 2~3 times higher than the normal value, then it indicates the necessity of further examination, timely detection of early symptoms of some diseases, and further examination and treatment as soon as possible.
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