How to read the physical examination report? Here is the "guide"!

On the medical examination report

What do the dense numbers mean?

What do the arrows next to the indicators mean?

What to do if indicators are abnormal?

Department of Health Sciences, Peking Union Medical College Hospital

Director Lin Songbai, attending physician Li Jing

Tell you how to understand the medical examination report

How to read the physical examination report?

The "Strategy" is here!

Meaning of symbols

↑ ↓: Numerical indicators all have reference ranges (in medicine, the range of a certain indicator for 95% of normal people is usually used as the reference value range). If the indicator value is not within this range, it will be marked as rising (↑) or falling (↓).

+ -: represent "yes" and "no", that is, the test results are positive and negative respectively.

±: represents an indeterminate positive result.

Tip: The appearance of an arrow does not necessarily mean that the indicator is abnormal or that you have a disease, and a positive result does not necessarily mean that there is a problem. For example, when the hepatitis B surface antibody is positive, it means that you have resistance, which is a good thing. It is recommended to focus on the summary of abnormal results and clear suggestions for the next step of treatment.

Complete blood test

The blood routine examination should focus on the "three systems", namely red blood cells (responsible for oxygen transportation), white blood cells (responsible for immune response), and platelets (responsible for blood clotting). A significant increase or decrease in the "three systems" indicates that there are certain problems. For example, a low level of white blood cells may lead to a decrease in the body's resistance, while a high level may indicate an inflammatory response or infection in the body.

The blood routine indicators of patients with different types of leukemia vary. Although some will show a significant increase in white blood cells, there are also cases where the white blood cell count does not increase or decreases, which is often accompanied by abnormal indications of other blood routine indicators. Usually, the most common cause of increased white blood cells is the body's inflammatory response.

cholesterol

Cholesterol is not entirely a "bad thing." High-density lipoprotein cholesterol protects blood vessels, so an increase in it is not a bad thing.

If low-density or non-high-density lipoprotein cholesterol is high, it indicates that the lifestyle needs to be improved. It is recommended to reduce the intake of greasy food and drink low-fat milk. However, if there is no intake of animal nutrients, the human body will lack essential nutrients such as vitamin B12, so this type of food cannot be completely avoided. The focus should be on controlling the intake of animal offal, fried foods, desserts, snacks, etc. It is recommended to exercise at least 5 times a week.

Dyslipidemia may also be related to genetic factors, and active drug treatment can be carried out under the advice of a professional doctor.

Tumor markers

The commonly used tumor markers are PSA (prostate-specific antigen), AFP (alpha-fetoprotein), CEA (carcinoembryonic antigen), and CA199 and CA125 of the carbohydrate antigen CA series. Some indicators whose names have nothing to do with tumors may also be related to tumors, such as ferritin, M protein, HCG, etc.

Men over 40 years old can screen for prostate cancer by regularly testing PSA. People with a history of chronic hepatitis and an increased risk of liver cancer should regularly test AFP. People with a family history of hereditary tumors and an increased risk of ovarian or pancreatic cancer can regularly test CA125 and CA199. However, tumor marker testing cannot replace imaging examinations or endoscopic examinations.

Tumor markers are correlated with tumors, but if you have a tumor, tumor markers may not necessarily increase, and an increase in markers does not necessarily mean you have a tumor. When tumor markers increase significantly and continue to increase, imaging examinations are often needed to find possible tumors. If you find that tumor markers are elevated, you should listen to the advice of professional doctors, complete necessary examinations, and observe the dynamic changes of indicators.

Urinalysis

Normal urine is light yellow and clear. The appearance of strong tea color or soy sauce color indicates that the urine may be abnormal. The normal range of urine pH is 4.5-8, but pathological changes in pH are often caused by acidosis. People who undergo routine physical examinations do not need to worry too much about changes in pH.

Most of the positive urine ketones in the physical examination report are caused by fat metabolites produced in fasting and hungry states. When people with no blood sugar problems have positive urine glucose, they should pay attention to check whether there is a problem with the renal tubular reabsorption capacity. Positive urine urobilinogen and urine bilirubin may also be related to some blood system diseases, and do not necessarily mean liver disease. It should be combined with blood indicators and abdominal ultrasound.

Normal urine can contain a small amount of red blood cells and white blood cells, but after excluding contamination factors, if the number of red blood cells and white blood cells increases, further examination is required. Patients with hypertension and diabetes are recommended to regularly perform urine ACR tests to detect urine microalbumin in order to detect early kidney damage and adjust medication in time.

Stool examination

Routine physical examination packages generally do not include colonoscopy. At this time, the most effective method for colorectal cancer screening is fecal occult blood, so don't give up easily. If there is no stool on the day of the physical examination, it can be collected and sent for examination on another day according to relevant requirements.

When fecal occult blood is positive, do not assume that it is "hemorrhoids". It is recommended that people over 50 years old or those with a family history of digestive system tumors complete gastrointestinal endoscopy. Young people should not take it lightly when fecal occult blood is positive, and at least three consecutive reexaminations should be performed.

Helicobacter pylori

Helicobacter pylori is a type of bacterium in the stomach that is associated with the incidence of gastritis, gastric ulcers, gastric cancer and gastric lymphoma, but there is still controversy as to whether it should be eradicated.

Current infection testing includes urea breath test, stool antigen and endoscopic urease test; infection trace testing requires blood drawing to detect antibodies. When the blood antibody is positive, it means that you have been infected with Helicobacter pylori.

In general, people with gastric diseases must undergo bactericidal treatment. The most commonly used is quadruple therapy, which is to take two antibiotics, bismuth, and acid suppressants for about 2 weeks. It should be noted that there must be evidence of current infection before deciding on treatment.

Other abnormal situations

Regarding "hyperplasia", "cysts", "nodules", "mass-occupying" and so on, the potential risks of lesions in different parts are different and cannot be generalized. For example, hyperplasia is a normal manifestation of breasts in women of childbearing age, and cysts are generally benign, but when cysts appear in the pancreas, kidneys, and ovaries, there is a potential risk of malignancy.

Breast, thyroid, and lung nodules that indicate level 4 or above should be viewed with caution. It is recommended to compare the physical examination reports of previous years and increase the frequency of observation for newly discovered cysts and nodules, observing the size changes every 3 months.

Gastrointestinal polyps may become malignant and should be removed promptly. Gallbladder polyps larger than 1 cm should generally be removed, and those that grow too fast should also be intervened in a timely manner. Most cervical polyps or endometrial polyps are benign, but when the polyps are large or clinical symptoms such as bleeding occur, removal may be considered.

Co-ordinators: Chen Fang, Wang Min

Reporter: Tian Xiaohang, Li Heng

Visual: Li Heng

Editor: Cao Jiayue

Produced by Xinhua News Agency Domestic Department

Source: Xinhua Viewpoint