The significance of five tumor marker tests in women

Unhealthy eating habits, irregular lifestyle and lack of exercise have made the incidence of cancer in this period more and more serious. Cancer screening is one of the most effective ways to prevent cancer. However, faced with the numerous types of anti-cancer screening in designated medical institutions, we can't help but wonder, which one is the most effective? Currently, common tumor screenings include invasive and minimally invasive. The general principle is to give priority to minimally invasive and radiation-free tests. If these tests are used and the disease cannot be diagnosed, then invasive and radiation-free tests should be chosen.

The practical significance of the five tumor marker tests for women

5 tumor markers for women: including AFP CEA CA19-9 CA15-3 CA125

AFP:

It is the most sensitive and specific indicator for the early diagnosis of primary liver cancer and is applicable to large-scale surveys. If the blood AFP value of an adult rises, it indicates the possibility of liver cancer. A significant increase in the AFP component generally indicates primary hepatocellular carcinoma. 70~95% of patients have elevated AFP. The more advanced the stage, the higher the AFP component. However, a negative result does not rule out primary liver cancer.

CEA:

CEA is an important tumor-related antigen and is difficult to detect in the blood of normal adults. 70-90% of patients with colorectal adenocarcinoma have a positive CEA aspect ratio. The detection rate in other malignant tumors is in the following order: gastric cancer (60-90%), pancreatic cancer (70-80%), small intestinal adenocarcinoma (60-83%), lung cancer (56-80%), liver cancer (62-75%), breast cancer (40-68%), and urinary system cancer (31-46%). The positive test rate of CEA in gastric acid (gastric cancer), sputum (oral cancer, nasopharyngeal cancer) and pleural effusion (lung cancer, liver cancer) is higher, because the CEA in these tumor "fluids" can exist in the blood. There is a certain correlation between CEA content and tumor size and whether it has metastasized. When liver metastasis occurs, the increase in CEA is particularly significant.

CA19-9:

It is a relevant marker for pancreatic cancer, gastric cancer, colorectal cancer, and gallbladder cancer. Many scientific studies have confirmed that CA19-9 concentration is related to the size of these tumors. It is the most sensitive marker for pancreatic cancer reported so far. 85%-95% of pancreatic cancer patients test positive.

CA15-3:

It is the most important specific marker for breast cancer. 30%-50% of breast cancer patients have significantly elevated CA15-3, and the changes in its composition are closely related to the treatment effect. It is the best indicator for diagnosing breast cancer patients, detecting postoperative recurrence, and observing efficacy.

CA125:

It is an optimal marker for ovarian cancer and endometrial cancer. If 65U/ml is used as the positive cutoff, the accuracy of stage III-IV lesions reaches 100%. CA125 is currently the most important indicator used for early diagnosis, outcome observation, prognosis analysis, and detection of onset and metastasis of ovarian cancer.

Standard value

AFP < 7.00 ng/ml;

CEA <5.00 μg/L;

CA19-9 <39.00 KU/L;

CA15-3 <25.00 KU/L;

CA125<35.00KU/L.

Clinical manifestations

Used for the selection, diagnosis and treatment of female tumors.

1. The AFP level reflects the size of the tumor to a certain extent. Its changing pattern is related to the disease condition and is a sensitive indicator for displaying treatment effect and prognosis.

Abnormal AFP values ​​generally indicate a poor prognosis, while elevated AFP values ​​indicate a serious condition. Generally, two months after surgical removal of liver cancer, the AFP value should drop to below 20ng/ml. If it drops very little or rises again after dropping, it indicates that the removal was incomplete or there is a possibility of recurrence or metastasis. In metastatic liver cancer, AFP values ​​are generally less than 350-400 ng/ml. In the obstetrics and gynecology department, AFP levels will also increase significantly in test tube embryonal carcinoma and uterine ovarian endoderm antrum carcinoma of the prostate. Mild to moderate increase in AFP is also common in patients with fatty liver cirrhosis, acute hepatitis and HBsAg virus carriers. Some digestive system cancers may also show elevated AFP levels. An increase in maternal blood cell or amniotic fluid AFP indicates that the fetus may have spina bifida, anencephaly, atresia or multiple births. A decrease in AFP (combined with maternal age) indicates that the unborn baby has risk factors for Down's syndrome. Normal standard value: 0-15 ng/ml2.

2. CEA measurement is mainly used to guide the treatment and follow-up of various tumors. Continuous observation of CEA concentrations in the blood of tumor patients or other blood can provide important basis for disease diagnosis, prognosis and efficacy observation.

The CEA test is extremely sensitive to postoperative tumor recurrence, reaching over 80%, and is usually earlier than clinical medicine, pathological examination and X-ray examination. Many clinical nurses have confirmed that the CEA concentration before surgery or treatment can determine the status of the tumor, survival time, and whether there are surgical indications. The lower the CEA concentration before surgery, the faster the disease progresses, the less likely the tumor will migrate and relapse, and the longer the survival time. On the contrary, the higher the CEA concentration before surgery, the later the disease progresses, the more difficult it is to remove, and the poorer the prognosis. During surgical removal of malignant tumors, continuous measurement of CEA will facilitate observation of efficacy. For those who underwent complete surgical removal, CEA levels generally returned to normal 6 weeks after surgery. For those with residual or micromigration after surgery, CEA levels decreased but did not recover. For those who could not remove the tumor and underwent palliative surgery, CEA levels generally continued to increase. The detection of CEA concentration value can also well reflect the effectiveness of radiotherapy and chemotherapy. Its effect is not necessarily proportional to the tumor volume. As long as the CEA concentration value can decrease with treatment, it is effective. If its concentration value does not change or even increases after treatment, the treatment plan must be changed. CEA testing can also be used to conduct long-term follow-up of patients whose CEA has recovered after surgery or other treatments to detect its recurrence and metastasis. The following schedule is generally adopted: once in the sixth week after surgery; once a month within three years after surgery; once every three months from 3 to 5 years; once every six months from 5 to 7 years; and once a year after 7 years. If an increase is found, test again two weeks later. If it increases twice, it indicates an onset and metastasis. Normal standard value: 0~5 ng/ml3.

3. CA19-9 measurement is helpful for the diagnosis and detection of pancreatic cancer. When CA19-9 is lower than 1000U/ml, surgical treatment has certain practical significance. After the tumor is removed, the CA19-9 concentration value will decrease. If it rises again, it may indicate an attack.

The diagnosis of pancreatic cancer metastasis also has a high detection rate. When the blood cell CA19-9 level is higher than 10000U/ml, venous metastasis is basically present. The detection rates of gastric cancer, colorectal cancer, gallbladder cancer, bile duct cancer, and liver cancer will also be very high. If CEA and AFP are tested in addition, the positive test rate can be further increased (for gastric cancer, it is recommended to do CA72-4 and CEA collaborative testing). CA19-9 levels may also increase in various healthy and inflammatory diseases of the digestive tract and liver, such as pancreatitis, mild biliary edema and jaundice, but they are usually "transient" and their concentrations are mostly less than 120U/ml, which requires comprehensive identification. Normal standard value: 0.1～27 U/.

4. Dynamic measurement of CA15-3 is helpful for the early detection of recurrence after treatment of patients with stage II and stage III breast cancer; when CA15-3 exceeds 100U/ml, migratory space-occupying lesions may be detected. The blood cell CA15-3 of patients with lung cancer, gastrointestinal cancer, ovarian cancer and cervical cancer may also be elevated and should be identified, especially to eliminate the increase caused by pregnancy. Normal standard value: 0.1～25 U/ml.

5. The combination of CA125 measurement and pelvic examination can improve the specificity of the experiment. The diagnostic accuracy of cervical adenocarcinoma, endometrial cancer, cervical cancer, breast cancer and mesothelial cell carcinoma is also very high, with a detection rate of only 2% for favorable lesions.

An increase in CA125 levels is a signal for the onset of female reproductive system tumors. Dynamic observation of blood cell CA125 concentration is helpful for prognosis evaluation and treatment control of ovarian cancer. After treatment, CA125 content can be significantly reduced. If it cannot be restored to the normal range, the possibility of residual tumor should be considered. 95% of patients with residual tumors have blood cell CA125 concentration values ​​exceeding 35U/ml. When ovarian cancer recurs, CA125 increases a few months before clinical diagnosis. The CA125 in the blood cells of patients with metastatic ovarian cancer is significantly higher than the normal standard value. Elevated CA125 can also be seen in ascites caused by various malignant tumors. Increased CA125 levels can also be seen in a variety of gynecological diseases, such as ovarian cysts, uterine wall diseases, cervicitis and uterine fibroids, gastrointestinal cancer, cirrhosis, hepatitis, etc. Normal standard value: 0.1～35