A middle-aged female patient (50 years old) who had been treated in the outpatient clinic found that the carcinoembryonic antigen was higher than the normal reference value during a health examination. The person in the physical examination department did not say anything, just let her come to the oncology department for consultation, she listened, to the oncology department for consultation, is it a tumor? So I was so frightened that when I came to my clinic, I was anxious.
I explained to her: "The indicator you checked, although it has the word cancer, may indeed have some relationship with tumors, but it is not necessarily related." In general, if it is significantly elevated, or if it is repeatedly reviewed for progressive elevation, that is, it is more than once elevated, most of it means that there is indeed a problem, if it is only a mild high, it does not mean that there is definitely a problem, do not worry too much. ”
She was very good at grasping words, and when she heard me say, "It doesn't mean there must be a problem," she said, "Then there may still be a problem." ”
Many people just like to listen to very affirmative words, like to listen to the words of patting the chest, do not know, medicine can not be too absolute, too absolute may be wrong.
I said, "Of course, I'm not saying that you're definitely okay, but that your value of this indicator is only slightly higher, and there is no problem that you can't see just by this indicator." There is no absolute thing in medicine, even if this indicator is completely normal, it does not mean that you are definitely fine, whether you have cancer, but it is not measured by this indicator, it is just a reference. Many factors can affect its results, and some benign diseases, such as inflammation, may also have a mild increase in carcinoembryonic antigens. ”
"Then why is it called carcinoembryonic antigen?" Since it is a carcinoembryonic antigen, how can it have nothing to do with cancer? Her question is also the confusion of most ordinary people.
"I didn't say it has nothing to do with cancer, it has a relationship, but it's not necessarily causal, the reason why it's called because it was originally found in the extract of colon cancer, and the antigen of this extract also appeared on embryonic cells, so it was called carcinoembryonic antigen." If you have cancer, this indicator may be elevated, but it may also be that this indicator is completely normal, and people who do not have cancer may also have a slight increase in this indicator. ”
"Doctor, you said, do I have cancer at all?" It seems that it is still not screwed up, Sweat!
"I have already said that I can't judge whether you have cancer by relying on this indicator alone, your indicator is only slightly higher, considering your age, you can review this indicator regularly, and you can consider adding some other markers, such as CA125, CA153, etc., which may have some reference significance for ovarian cancer and breast cancer, but it is only a reference." Leave these indicators aside for the time being, whether these indicators are normal or elevated, as a middle-aged woman of your age, you should undergo some necessary cancer screening, especially breast cancer, cervical cancer and so on. ”
"Oh, well, doctor, you can arrange a test for me, I'm really not at ease."
"Of course you can."
I asked her in detail about her occupation, family history, etc., according to her age, targeted arrangements for breast cancer, cervical cancer and other screenings, the final results are normal, for the time being, no obvious problems were found, she said "finally a sigh of relief." I told her that normal screening results do not mean that you can sit back and relax from now on, and you still have to check regularly in the future.
Speaking of this, the story seems to be over, but I think it certainly does not completely solve the doubts in everyone's minds, and many people may ask, what is the value of "carcinoembryonic antigen"? Should the physical examination check this indicator?
Carcinoembryonic antigen is one of the most commonly seen tumor markers, and it is indeed related to tumors, but it is not a completely reciprocal relationship. The rise of carcinoembryonic antigen suggests that we should pay attention to the exclusion of epithelial malignancy, which was first found in the extract of colon cancer, so once it is found to be significantly elevated, we must first think of the possibility of digestive system tumors such as pancreatic cancer, colon cancer, and stomach cancer. Of course, its significance is not only this, it also has reference value for lung cancer, breast cancer, ovarian cancer, etc., and also has certain suggestive significance for bladder cancer, cervical cancer, endometrial cancer, etc. In general, the higher its value rises, the more clear the meaning, the more advanced the cancer in general, or the more extensive the cancer foci, the higher the value of the carcinoembryonic antigen, but not necessarily, because the value of advanced cancer may not be too high, and even normal may be possible. Since many cancers may have elevated carcinoembryonic antigens, carcinoembryonic antigens do not do much to identify which cancer it is.
In addition, the carcinoembryonic antigen also has reference value for the prognosis judgment of cancer patients, such as patients with normal levels of carcinoembryonic antigen before surgery, its surgical cure rate may be higher, and the probability of recurrence after surgery may be lower, and patients with preoperative carcinoembryonic antigen has been significantly elevated, most of them may have vascular walls, lymphatic systems and peripheral invasions and metastasis, often indicating prognosis deviations, may be more prone to recurrence. At the same time, for cancer patients with significantly elevated carcinoembryonic antigens before treatment, it can also be used as a reference index for whether it is effective after treatment, or it also has certain reference value for disease monitoring and follow-up. During colorectal cancer treatment and follow-up, carcinoembryonic antigen is a very effective monitoring indicator, and it is an ideal indicator of recurrence, and its sensitivity to finding recurrence is even higher than that of X-rays and colonoscopy. Finally, it must be emphasized that elevated carcinoembryonic antigens are not necessarily cancerous, such as people who smoke, have ulcerative colitis, pancreatitis, colon polyps, and active liver disease, and carcinoembryonic antigens may also be elevated. Therefore, if the carcinoembryonic antigen is found to be elevated, it should be paid attention to, but it is necessary not to hope that Wen Shengyi will cause unnecessary panic, consult an oncologist, interpret it according to the specific situation, and arrange further examination or observation follow-up as appropriate.
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