Let's talk about tumor markers

Many people are both familiar and unfamiliar with the term "tumor marker". People will come into contact with it when they go to the hospital for treatment or regular physical examinations. Most people complete this test item through blood tests. Some people have elevated test items, worrying and anxious, and suspecting that they have a malignant disease. If this test item is elevated, does it mean that we have a tumor? What should we pay attention to if it is elevated? Today, let's learn about the test item "tumor marker" with everyone, and understand the meaning of abnormal results, so that we can prevent it from happening and stay healthy.

What is a tumor marker? The medical definition of a tumor marker is: a substance produced directly by tumor cells or synthesized by non-tumor cells after being induced by tumor cells. It can be detected through human body fluids (including blood, urine, pleural effusion, etc.). Characteristics of tumor marker detection: 1. High sensitivity, almost all tumor patients will have an increase; 2. Good specificity: can distinguish between tumor patients and non-tumor patients; 3. Organ specificity: can help determine what type of tumor; 4. The concentration of tumor markers is related to the size, metastasis and malignancy of the tumor; 5. Exists in body fluids and is easy to detect.

Below are two hospital test receipts, which are what we often call "tumor markers". It is divided into male items and female items. There are also many testing institutions that are composed of multiple items, and the physical examination items are only some of them. We can interpret them one by one according to the order of the items on the test sheet so that everyone can understand them accordingly.

① Alpha-fetoprotein AFP: The most sensitive and specific marker for primary liver cancer. It may be elevated in viral hepatitis, cirrhosis, and embryonic cell tumors (testicular cancer, teratoma). It may also be elevated in gastric cancer, gallbladder cancer, pancreatic cancer, etc. It may be elevated in pregnant women and return to normal after delivery. AFP false positives can be seen in benign liver diseases. ② Carcinoembryonic antigen CEA: It can be elevated in various tumors, and some benign diseases such as intestinal polyps, colitis, cirrhosis and lung diseases can also be elevated. ③ Sugar chain antigen 125, namely CA125: Gynecological tumors are most sensitive to ovarian cancer, and can also be seen in breast cancer, pancreatic cancer, gastric cancer, lung cancer, and colorectal cancer. Benign diseases including endometriosis, pelvic inflammatory disease, ovarian cysts, pancreatitis, and hepatitis cirrhosis can also be elevated. ④ Sugar chain antigen 153, namely CA153: CA153 is often elevated in breast cancer, and other malignant tumors such as lung cancer, kidney cancer, colon cancer, pancreatic cancer, ovarian cancer, cervical cancer, and primary liver cancer. ⑤ CA199: The positive rate of pancreatic cancer, gallbladder cancer, and bile duct cancer is high, and gastric cancer, liver cancer, rectal cancer, and breast cancer may also be elevated. Benign diseases such as pancreatitis, cholecystitis, cholestasis, and cirrhosis may also be elevated. ⑥ CA72-4: It is elevated in gastric cancer and ovarian cancer, and other tumors such as colon cancer, pancreatic cancer, and non-small cell lung cancer can also be elevated. ⑦ CYFRA211: It is common to increase non-small cell lung cancer, and it can also increase bladder cancer, prostate cancer, ovarian cancer, colorectal cancer, and pancreatic cancer. Benign diseases are also commonly elevated: lung diseases, gastrointestinal diseases, gynecological diseases, and urinary tract diseases. ⑧ Squamous cell carcinoma-related antigen, SCC: Squamous cell carcinoma is common, such as cervical cancer, lung cancer, head and neck cancer, nasopharyngeal cancer, etc. Benign diseases such as hepatitis, tuberculosis, and psoriasis may also be elevated. ⑨ Neuron-specific enolase or NSE: It can be elevated in lung cancer, neuroblastoma, seminoma, and other neuroendocrine tumors, such as pheochromocytoma and melanoma. It can also be elevated in benign brain diseases and lung diseases. ⑩ Prostate-specific antigen or PSA: It can be elevated in prostate cancer, and other kidney cancers, bladder cancer, and adrenal cancers, but it is uncommon. It can also be elevated in prostate hyperplasia, prostatitis, and genitourinary diseases. Ferritin FER also appeared in the test report. This test has poor specificity as a tumor marker and is affected by many factors, so it is not very meaningful for detecting early tumors. Similarly, the same is true for gastrin release precursor, which is affected by many factors. Many benign diseases such as gastritis have elevated levels. Some medical institutions have excluded these two tests.

The above comprehensively introduces the diseases in which these tumor marker items are elevated. It can be seen that many benign diseases can also cause these markers to increase. So how do you know whether you are caused by a benign disease or there is really a possibility of cancer? If a single tumor marker is elevated, it is generally more clinically significant if it is higher than twice its normal upper limit. If a single tumor marker is only slightly higher than the normal upper limit, there is generally no need to worry. However, if several tumor marker items are elevated at the same time, ≥ three items, even if the values ​​are not much higher, you should pay full attention and go to the hospital for further examination. Many people have elevated tumor markers caused by benign diseases such as gastritis and intestinal polyps. As the disease is cured, the test indicators will also drop to the normal range. If the test value of your own tumor marker is really more than twice as high, or there has been no increase in the previous physical examination, and this physical examination finds a significant increase, it is recommended to go to the hospital for treatment in time. Complete relevant examinations based on the specific items that are elevated. For example, if AFP is significantly elevated, focus on improving the examination of the abdomen and liver; if CA153 is significantly elevated and accompanied by breast nodules, focus on improving the examination of the breast; if only CEA is significantly elevated, because it has the widest range of indications and cannot be specifically associated with any body system, a relatively complete examination is needed to clarify.

The detection of tumor markers can not only provide a basis for physical examinations for healthy people and help detect diseases early, but also provide early warnings for sick people. Clinically, many patients who have been diagnosed with malignant tumors will have baseline tests and examinations. Tumor markers will decrease as the tumor shrinks and heals, and will also increase as the tumor load increases, that is, when the disease recurs or metastasizes. Tumor markers are an important basis for indicating the stability of the disease.

In summary, when you find that your tumor marker test values ​​are elevated, don't be anxious. First, make a preliminary judgment whether your test values ​​are much higher than normal. If a single indicator is slightly elevated without any discomfort, or the value has not changed significantly for many years, in most cases, there is no need to worry. If multiple indicators are elevated or a single indicator is elevated a lot, you need to pay enough attention and go to the hospital as soon as possible to find out the cause of the increase and detect the disease early. I hope the above explanation can help you understand "tumor markers", understand your physical condition in a timely manner, and prevent early diseases.