Interpretation of tumor markers

Tumor markers are synthesized by the tumor cells themselves, or the release of tumor cells and produce a reaction substances increased, incl

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Tumor markers are synthesized by the tumor cells themselves, or the release of tumor cells and produce a reaction substances increased, including proteins, carbohydrates and enzymes. It can be determined by chemical, immunological and genomic methods. The detection of tumor markers can only be used as a reference for the diagnosis of cancer patients, and can not be used as the basis for diagnosis. Although the detection of tumor markers in the blood of patients may be increased, it may indicate the presence of tumor or the possibility of tumor recurrence and metastasis. Tumor markers are not one-to-one correspondence with tumor, and the proportion of false negative and false positive is not low.

The detection of tumor markers is of great practical value in tumor screening, diagnosis, prognosis and prognosis, evaluation of therapeutic efficacy and follow-up observation of high-risk groups. For the same kind of tumors or different tumor types may have one or several abnormal, and the same kind of tumor markers may occur in different tumors, it may choose 2 ~ 3 sensitivity and specificity of highly complementary tumor marker combination, joint detection. The role of tumor markers in screening for high-risk populations.

Tumor markers can be used in high-risk groups (such as family history of tumor, long-term smoking history, drinking history, history of chronic hepatitis B) screening, examination of tumor markers in the following: 1 people have promoted or risk factors lead to the occurrence and development of tumors, such as tumor family heredity, long-term unhealthy eating habits. Poor living and working environment. The clinical manifestations of 2 with tumors, such as vaginal bleeding with blood, mucus, pus and blood, phlegm in postmenopausal women. 3 other auxiliary examination results, such as color Doppler ultrasound, CT, MRI and other test results prompted or suspected tumor. The examination of tumor markers usually requires a certain amount of venous blood.

For some people with high tumor markers, such as no obvious symptoms, and imaging findings were not found, it is generally recommended after January review and follow-up. If the psychological burden is heavier, you can directly to the higher level or other hospitals with the same level of direct review. Due to various factors, such as blood, precision and other factors will affect the index, many people will be found when the index has been reviewed. However, if the tumor markers are very high, several times or even several times higher than normal values, or tumor markers continued to increase, the need for further cancer screening work."

The concentration of tumor markers can be affected by the following factors: 1 tumor cells, tumor mass, total tumors and tumor grade level; 2 tumor markers synthesis and release rate; 3 individual tumors do not carry or no expression of tumor markers, non secreting tumor can express tumor markers, but will not release in human body fluid; 4 if the tumor blood supply is poor, then reach the tumor markers in peripheral blood may be less; 5 such as a large number of tumor cell disintegration, may increase the concentration of tumor markers, the size may significantly disproportionate tumor marker concentration and tumor; 6 if the body symptoms of metabolic disorders, such as liver and kidney failure. Some tumor markers will be disproportionately increased concentration.

Some non tumor factors can also lead to positive tumor markers. For example: viral hepatitis, cirrhosis can lead to increased AFP; smoking increased CEA; benign prostatic hyperplasia, prostatitis can cause increased PSA; acute cholangitis, acute and chronic pancreatitis, cholestasis, liver cirrhosis, chronic active hepatitis can cause increased CA19-9; menstrual period, heart failure, cirrhosis, chronic active hepatitis can cause increased CAl25; pregnancy HCG, marijuana can be increased.

In general, the sensitivity and specificity of the commonly used tumor markers in the diagnosis of malignant tumors is not high enough, so it is mainly used for the auxiliary diagnosis of tumor, and can not be diagnosed by tumor markers positive.

The diagnosis of the tumor should be based on the patient's history, clinical manifestations, laboratory tests and / or imaging examinations, which can be diagnosed only after comprehensive judgment. Because of the low specificity of most tumor markers, tumor markers can not be used to locate the tumor. But a few tumor markers, such as primary liver cancer alpha fetoprotein (AFP), prostate specific antigen for prostate cancer (PSA) and thyroglobulin in thyroid carcinoma (TG) of the organ has a certain value orientation.

There is a certain relationship between the change of tumor markers and therapeutic effect in the treatment and follow-up of cancer patients. 1 tumor markers decreased the concentration to the reference range or decreased by more than 95%, suggesting that tumor treatment is effective; 2 tumor markers were decreased but continued in the reference range, suggesting residual tumor and (or) metastasis; 3 tumor marker concentrations decreased to the reference range after a period of time, and increased again. Tumor recurrence or metastasis.

 

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