Many friends have such a question, can tumor markers detect tumors? Maybe sometimes the answer you get is likely to be that it doesn't matter if the tumor marker is elevated, it is often caused by benign lesions, and regular review can be done. But if it is a tenfold increase, it must be paid attention to, and the possibility of tumor existence is very large. In fact, this understanding is not entirely correct. Because some malignant tumors or certain cancers, the tumor markers are not obvious, or even not elevated, not all cancers will significantly increase the indicators of tumor markers by several times or even dozens of times. In this regard, Dr. Xie Peng, a young expert on tumor markers, once told me a case of his experience, which is more typical, and introduced it to you.
A 62-year-old male patient went to dr. Xie Peng's hospital for treatment because of the pain in his left upper quadrant in the past 3 months, occasionally accompanied by malignancy and vomiting, and his weight had dropped by about 20 pounds. The outpatient doctor asked the patient to do a tumor marker test, and then, the patient's tumor marker report sheet showed only a slight increase in CA199, 30.2 (normal value less than 27). At this time, if it is not familiar with the tumor marker doctor will tell the patient that it is okay, there is no sign of cancer in the body, regular review can be, then things will develop in the wrong direction. At that time, Dr. Xie Peng very decisively told the patient that although the level of tumor marker elevation is not high, but combined with your symptoms, it is recommended to do another gastroscopy, if the lesion is found, then see if it can be surgically removed, if the lesion is negative, and then further consider the following problems. Later, the patient went for gastroscopy, and sure enough, he found that a tumor had grown on the stomach, and the pathology after resection showed stomach cancer. Through such a case, I want to explain to you that we must pay attention to the combination of test results and the patient's clinical history, imaging data, etc. to analyze, so as to be able to give an accurate diagnosis.
During the embryonic period, the fetus's pancreas, gallbladder, liver, intestine and other tissues have this antigen, which is very small in normal human tissues. Detecting patient serum CA199 can be used as an auxiliary diagnostic index for pancreatic cancer, gallbladder cancer and other malignant tumors, and is also of great clinical significance for monitoring changes and recurrence of patients' conditions.
For pancreatic cancer, gallbladder cancer, and cholangiocarcinoma, CA199 is generally more obviously elevated, especially pancreatic cancer, with a positive rate of more than 75%, so CA199 is also one of the important indicators to assist in the diagnosis of pancreatic cancer. In addition, CA199 is also of great value for the observation of efficacy, prognosis, and the diagnosis of recurrence and metastasis. In other words, if a patient with pancreatic cancer has a significant decrease in the value of CA199 after treatment, it means that the effect of treatment is more ideal, on the contrary, if the patient receives treatment, CA199 is more obviously elevated, it means that the treatment has not played its due effect. In addition, after the treatment of a patient with pancreatic cancer, CA199 returned to a very low level, and in the process of follow-up, there was a gradual increase or even a significant increase in CA199, at which point it was necessary to suspect whether there was a recurrence or metastasis. In the same way, for the determination of all tumor markers, we can basically follow this law. In fact, there are also certain positive rates in other tumors, such as a 50% positive rate for stomach cancer, a 60% positive rate for colorectal cancer, and so on.
In fact, for lung cancer, liver cancer and other diseases, there may also be an increase in CA199. CA19-9, a tumor marker of the digestive system, also has a certain similarity with CA-50. Of course, certain benign diseases can also cause an increase in CA199. For example, hepatitis, pancreatitis, pneumonia cholecystitis, cirrhosis of the liver, etc., this is also what we need to pay attention to.
Therefore, every time we talk about whether tumor markers can diagnose tumors, my suggestion is that in some cases, tumor markers can indicate tumors, but it is not possible to rely entirely on the change of tumor markers to make a diagnosis, and it is also necessary to make a comprehensive assessment based on the patient's medical history and other related test results, so as to make an effective diagnosis.
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