Relationship between tumor markers and tumor

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Tumor markers are items to be checked for patients with cancer, including many healthy people will also appear in the physical examination p


Tumor markers are items to be checked for patients with cancer, including many healthy people will also appear in the physical examination project. This is a cheap and good indicators, but it is also very easy to trouble the indicators of the patient, and now a simple summary of the most common significance of several markers.

1, alpha fetoprotein (AFP)

AFP is the fetal liver and yolk sac a glycoprotein synthesis, in normal adult blood circulation in the content is little than 20 mu g/L. AFP is the best marker for the diagnosis of primary liver cancer, the positive rate is 60% ~ 70%. Serum AFP > 400 g/L lasting for 4 weeks, or for a period of 200 to 400 g/L for up to 8 weeks, combined with imaging examination, the diagnosis of primary liver cancer can be made. The concentration of AFP in serum of patients with acute and chronic hepatitis and cirrhosis can be increased to varying degrees, and its water content is usually 300ug/L. The AFP content was increased in the germ cell tumors (testicular cancer and teratoma). 2, carcinoembryonic antigen (CEA) carcinoembryonic antigen (CEA) is a kind of glycoprotein embryo antigen, which is found in the fetus and colon cancer. The normal reference value of serum CEA was less than 5 g/L. The positive rates of CEA in malignant tumors were colorectal cancer (70%), gastric cancer (60%), pancreatic cancer (55%), lung cancer (50%), breast cancer (40%), ovarian cancer (30%), and uterine cancer (2). Some benign diseases such as rectal polyps, colitis, cirrhosis, and pulmonary disease also have elevated levels of CEA, but the degree of increase and the positive rate are low. CEA is an adhesion molecule, which is an important marker of tumor metastasis and recurrence. 3, cancer antigen 125 (CA125) CA125 in epithelial ovarian cancer tissue and serum in patients with ovarian cancer markers is of the most important, in the application of early screening, diagnosis, treatment and prognosis. The sensitivity of CA125 to ovarian epithelial carcinoma is about 70%. Other non ovarian malignant tumors (cervical cancer, uterine cancer, endometrial cancer, pancreatic cancer, lung cancer, gastric cancer, colorectal cancer, breast cancer) also have a positive rate. Benign gynecological diseases (pelvic inflammatory disease, ovarian cysts, etc.) and early pregnancy may appear to varying degrees of elevated serum CA125 levels. 4, cancer antigen 15-3 (CA15-3) CA15-3 can be used as an adjuvant diagnosis of breast cancer, postoperative follow-up and the indicators of metastasis and recurrence. The sensitivity of early breast cancer was low (60%), the late sensitivity was 80%, and the positive rate of metastatic breast cancer was higher (80%). Other malignant tumors also have a certain positive rate, such as: lung cancer, colon cancer, pancreatic cancer, ovarian cancer, cervical cancer, primary liver cancer, etc.. 5, carbohydrate antigen 19-9 (CA19-9) CA19-9 is a kind of carbohydrate antigen associated with gastrointestinal cancer, usually distributed in normal fetal pancreas, gallbladder, liver, intestine and normal adult pancreas, bile duct epithelium, etc.. Detection of serum CA19-9 in patients with pancreatic cancer, gallbladder cancer and other malignant tumors of the auxiliary diagnostic indicators, to monitor the disease changes and recurrence of great significance. The levels of serum CA19-9 in patients with gastric cancer, colorectal cancer, liver cancer, breast cancer, ovarian cancer and lung cancer were also increased in different degrees. Some digestive tract inflammation CA19-9 is elevated in different degrees, such as acute pancreatitis, cholecystitis, cholangitis, cholestasis hepatitis and liver cirrhosis. 6, cancer antigen 50 (CA50) CA50 is a marker of pancreatic and colorectal cancer, is the most commonly used carbohydrate antigen tumor markers, because of its widespread pancreas, gallbladder, liver, stomach, colon, bladder, uterus, tumor recognition of its spectrum wider than CA19-9, so it is also a common tumor sign associated antigen, rather than specific organ tumor markers. CA50 positive rate is different in a variety of malignant tumors, carcinoma of the pancreas and gallbladder cancer positive rate ranks first, accounting for 94.4%; followed by liver cancer (88%), ovarian and uterine cancer (88%) and malignant pleural effusion (80%) etc.. It can be used in the early diagnosis of pancreatic cancer, gallbladder cancer, and so on. It also has a high value in the diagnosis of liver cancer, gastric cancer, colorectal cancer and ovarian cancer. 7, carbohydrate antigen 242 (CA242) CA242 is associated with pancreatic cancer, gastric cancer, colorectal cancer associated glycolipid antigen. Serum CA242 was useful in the diagnosis of pancreatic cancer and colorectal cancer, with good sensitivity (80%) and specificity (90%). Serum CA242 levels were elevated in patients with lung cancer, liver cancer and ovarian cancer. 8, gastric cancer associated antigen (CA72-4) CA72-4 is currently the best tumor marker for diagnosis of gastric cancer, with high specificity for gastric cancer, the sensitivity can reach 28-80%, and if CA19-9 and CEA combined detection of gastric cancer can monitor more than 70%. The level of CA72-4 was significantly correlated with the stage of gastric cancer, which was generally higher in the stage of gastric cancer, and the positive rate of CA72-4 was higher than that of non metastatic patients. The level of CA72-4 decreased rapidly to normal after operation. In 70% of the recurrent cases, the CA72-4 concentration increased. Compared with other markers, the main advantage of CA72-4 is that it has a very high specificity for the differential diagnosis of benign lesions, and the detection rate is only 0.7%. Colorectal cancer, pancreatic cancer, liver cancer, lung cancer, breast cancer, ovarian cancer, there is a certain positive rate. 9, ferritin (SF) ferritin levels seen in tumor following acute leukemia, He Jie's disease, lung cancer, colon cancer, liver cancer and prostate cancer. Detection of ferritin is valuable in diagnosis of metastatic liver cancer patients, 76% hepatic metastasis ferritin levels higher than 400 g/L, detection of hepatocellular carcinoma, AFP value were lower, available iron protein determination value added, in order to improve the diagnostic rate. Ferritin increases in pigmentation, inflammation, and hepatitis. The reason for the increase may be due to cell necrosis, the formation of red blood cells is blocked or the synthesis of tumor tissue increased. 10, prostate specific antigen (PSA) PSA is a glycoprotein synthesized by human prostate epithelial cells and secreted in the seminal plasma, PSA mainly exists in the prostate tissue, the female body does not exist, the content of PSA in serum of normal male low serum reference values is less than 4 g/L; PSA with organ specific, but not with tumor specific. The positive rate of prostate cancer was 80%. Serum levels of PSA were increased in benign prostatic diseases. Determination of serum PSA is a monitoring index for postoperative recurrence and metastasis of prostate cancer. PSA exists in two forms: free PSA and bound PSA. The ratio of free PSA and total PSA (F-PSA/T-PSA) is an effective marker for differential diagnosis of prostate cancer and benign prostate disease. F-PSA/T-PSA 0.25 is a benign disease; F-PSA/T-PSA = 0.16 highly suggestive of prostate cancer.

11, prostate acid phosphatase (PAP) prostate cancer serum PAP increased, prostate cancer diagnosis, staging, curative effect observation and prognosis of important indicators. Prostatitis and prostate hyperplasia PAP also has a certain degree of increase. 12. The expression of beta 2-m (beta 2-MG) beta 2 (2-microglobulin) was expressed on the surface of most nucleated cells. It is widely used in the diagnosis of lymphoproliferative diseases, such as leukemia, lymphoma and multiple myeloma. The level was related to the number of tumor cells, growth rate, prognosis and disease activity. In addition, according to this level can also be used in patients with myeloma stage. Serum 2-MG can be increased in renal failure, inflammation and various diseases. Therefore, it is necessary to exclude the increase of serum 2-MG due to some inflammatory diseases or glomerular filtration function. 13, neuron specific enolase (NSE) NSE is a kind of enolase isozymes. NSE is a tumor marker of small cell lung cancer (SCLC), and the positive rate is 91%. Differential diagnosis of small cell lung cancer and non-small cell lung cancer (NSCLC). It is important to observe the curative effect and relapse of small cell lung cancer. The serum NSE concentration of neuroblastoma and neuroendocrine tumor cells was significantly increased. 14, cytokeratin 19 (Cyfra21-1) Cyfra21-1 is a soluble fragment of cytokeratin -19. Cyfra21-1 is the preferred marker for non-small cell lung cancer, especially lung squamous cell carcinoma. Combined detection of CEA and NSE has important value in the differential diagnosis of lung cancer. Cyfra21-1 is also a good marker for breast cancer, bladder cancer and ovarian cancer. 15, squamous cell carcinoma antigen (SCCA) of squamous cell carcinoma antigen (SCCA) was extracted from cervical squamous cell carcinoma tumor associated antigen TA-4, low serum content of normal people is less than 2.5 g/L. SCCA is a tumor marker of squamous cell carcinoma, which is suitable for the diagnosis and treatment of cervical cancer, lung squamous cell carcinoma, esophageal cancer, head and neck cancer and bladder cancer. 16, nuclear matrix protein -22 (NMP-22) NMP- 22 (NuclearMatrixProtein-22) is a component of the nuclear skeleton. It is closely related to DNA replication, RNA synthesis, gene expression and hormone binding. A large number of tumor cells apoptosis and the release of NMP22 into the urine in bladder cancer, urinary NMP22 can be increased by 25 times. The sensitivity of 10kU/mL for the diagnosis of bladder cancer was 70% and the specificity was. The sensitivity of invasive bladder cancer was 100%. 17, alpha -L- fucosidase (AFU AFU) is a new marker of a sensitive and specific primary hepatocellular carcinoma detection. The activity of serum AFU in patients with primary liver cancer was significantly higher than that of other kinds of diseases, including benign and malignant tumors. The dynamic curve of serum AFU activity plays an important role in judging the therapeutic effect, predicting prognosis and predicting recurrence of liver cancer, and it is better than AFP. However, it is noteworthy that the serum AFU activity was measured with some overlap between the metastatic liver cancer, lung cancer, breast cancer, ovarian or uterine cancer, even in some non neoplastic diseases such as chronic hepatitis, liver cirrhosis and gastrointestinal bleeding also increased slightly, in the use of AFU should be measured simultaneously with AFP, can to improve the diagnosis of primary liver cancer rates have complementary effect better.

Detection of tumor markers (TM) is of great significance:

Tumor screening

Who is looking for suspicious tumor screening in the asymptomatic crowd. Detection of tumor markers is an effective method for primary screening of tumor. High risk population screening. AFP: screening for primary liver cancer. Screening for prostate cancer in men over the age of PSA:50. High risk HPV: screening for cervical cancer. CA125+ ultrasound: screening for ovarian cancer in women over the age of 50. Tumor markers were abnormally elevated, with no obvious symptoms and signs. If continued to increase, should be diagnosed in a timely manner.

Two, diagnosis

Auxiliary diagnosis: the specificity of tumor markers is not strong enough, it can not only diagnose tumor according to tumor markers, but can provide further clues. Differential diagnosis: Bence Jones protein, AFP, HCG, PSA and other characteristics of the cancer. Localization of tumor markers: lack of tissue specificity. Dynamic observation: the progressive increase of tumor markers is of definite diagnostic significance; the markers of benign diseases are increased as transient; the markers of malignant tumors are increased to be persistent.

Three, monitoring the condition and efficacy

Monitoring therapeutic effect, recurrence and metastasis are the most important clinical application of tumor markers. After tumor surgery, chemotherapy or radiotherapy, there is a good correlation between the level of tumor markers and the curative effect.

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