Learn about tumor markers

Author: Li Shengmin, Zhongshan Hospital Affiliated to Dalian University

Tang Shunxiong Zhongshan Hospital Affiliated to Dalian University

Reviewer: Zhou Jun, Chief Physician/Associate Professor, Zhongshan Hospital Affiliated to Dalian University

As the public's understanding of malignant tumors continues to deepen, tumor markers have become one of the most discussed and most concerned indicators during physical examinations for middle-aged and elderly people, and even some young people. During the physical examination, if an elevated tumor marker is found, does it mean that you have unfortunately developed a malignant tumor? What should you do next? Today we will take you to learn more about tumor markers.

1. What are tumor markers?

Generally speaking, tumor markers are enzymes, hormones, glycoproteins and other substances produced by tumors and wearing a tumor-specific "coat". Just like a peach, the tumor marker is the peach pit, and the peach flesh is its tumor-specific "coat".

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Tumor markers play a very important role in the diagnosis, treatment and prognosis of malignant tumors. Ideally, once the tumor marker index increases, it can be determined that a malignant tumor has been diagnosed; when the index is normal, we can rule out malignant tumors. However, there is currently no known tumor marker that can fully meet this definition and achieve this goal.

What are the common tumor markers?

At present, more than a hundred tumor markers have been discovered, which can be detected through blood tests, pleural effusion and ascites samples, etc.

Alpha-fetoprotein (AFP): Common in hepatocellular carcinoma, tumors in other parts of the body, such as the ovaries and testicles, may also cause it to increase.

Carcinoembryonic antigen (CEA): One of the most common tumor markers, it is often elevated in malignant tumors of the digestive system; it also has a certain predictive effect on malignant tumors of the urogenital, respiratory and endocrine systems.

Carbohydrate antigen 199 (CA-199): A relatively sensitive tumor marker of the digestive system, with the highest sensitivity to pancreatic cancer.

Neuron-specific enolase (NSE): mainly indicates neuroendocrine tumors.

Squamous cell carcinoma-associated antigen (SCC): It is common in tumors in the lungs, trachea, esophagus, head and neck, cervix, anal canal, etc.

Prostate-specific antigen (PSA): Testing for elevated PSA is an effective method for early detection of prostate cancer in older men.

Calcitonin (CT): It can indicate well-differentiated medullary thyroid carcinoma; it may also be present in other tumors with endocrine functions, such as small cell lung cancer.

Human chorionic gonadotropin (hCG): HCG is usually used to detect whether women of childbearing age are pregnant. When hCG rises, pregnancy should be considered first. If patients with irregular menstruation or a recent history of miscarriage have a continuous increase in hCG, the possibility of choriocarcinoma should be considered.

Carbohydrate antigen 125 (CA-125): Associated with ovarian malignancy.

3. What conditions can lead to elevated tumor markers?

Most tumor marker indicators are relatively specific, which means that the indicators of patients diagnosed with malignant tumors may not be elevated, while the indicators of patients without malignant tumors may be elevated.

Inflammation (such as the digestive system, urinary and reproductive system, respiratory system), polyps, inflammatory proliferative lesions, liver and kidney decompensation, etc. may cause a slight increase in tumor marker indicators, that is, a "false positive".

In addition, factors such as sampling quality, operational factors, and reagent type will also affect the accuracy of tumor marker test results.

4. What should we do when tumor markers are elevated?

Generally speaking, if the tumor marker is slightly higher than the upper limit of normal value and there are no obvious suspicious symptoms or the specificity of the tumor marker is very low, the test can be repeated after 2 to 4 weeks.

If the tumor markers are significantly elevated or continue to be elevated, people should undergo further examinations for related diseases and complete imaging examinations to clarify the diagnosis.

5. Are malignant tumors contagious?

Malignant tumors are caused by gene mutations in autologous cells and are not contagious, but some carcinogenic factors are contagious.

For example, bacteria (Helicobacter pylori) and viruses (human papillomavirus, hepatitis virus, Epstein-Barr virus, etc.) that are closely related to malignant tumors are contagious.

Therefore, maintaining personal hygiene, developing healthy living habits, and timely vaccination can effectively prevent related bacterial and viral infections, thereby preventing the occurrence of malignant tumors.

6. How to prevent malignant tumors

The World Health Organization considers malignant tumors to be a lifestyle disease.

Smoking, alcoholism, obesity, irregular diet, mental stress, long-term high pressure, etc. are all risk factors for malignant tumors.

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Quitting smoking, drinking, eating a balanced diet, exercising moderately, and maintaining a good mood can effectively reduce the incidence of malignant tumors.

The emergence of malignant tumors is the accumulation of relevant risk factors during our life cycle. Therefore, the prevention and control of malignant tumors is not just a matter for middle-aged and elderly people!

We must develop a healthy lifestyle from now on, avoid exposure to high-risk carcinogenic factors, and reduce the risk of malignant tumors!