Many people think about going to the medical examination during the holidays. A few days ago, a good friend sent me their company's medical examination program, and some of them caught my attention.
These are all cancer-related tests, let's analyze which cancers can be detected? (By the way, see if the company's physical examination is valuable).
1
HPV typing test (female)
The main purpose of this test is to detect the presence of the HPV virus. Persistent infection with high-risk HPV virus is a major risk factor for cervical cancer. The data show that 90% of cervical cancers are accompanied by HPV infection.
2
Prostate tumor marker combination (male)
Prostate-specific antigen (PSA) has a positive rate of 30% to 86% in prostate cancer, which is of great significance for the early diagnosis of prostate cancer without symptoms. However, this indicator will also increase when men have prostatic hyperplasia and prostatitis, so the specificity for diagnosing prostate cancer is not high.
However, the ratio of F-PSA/T-PSA can compensate for these deficiencies and help distinguish between prostate cancer and benign hyperplasia.
F-PSA: Free prostate-specific antigen
T-PSA: total prostate-specific antigen
03
Alpha-fetoprotein quantification (AFP)
Alpha-fetoprotein is a commonly used test for the diagnosis of primary liver cancer, and about 87% of patients with primary liver cancer have abnormal indicators.
04
Carcinoembryonic antigen quantification (CEA)
This is a broad-spectrum tumor marker with a certain percentage of elevated blood tests in patients with bowel, stomach, urethral, ovarian, lung, pancreatic, breast, medullary thyroid, bladder, and cervical cancer.
However, certain benign conditions can also cause an increase in this indicator, such as smoking, ovarian mucostic cystic adenoma, cholecystitis, cirrhosis, inflammatory bowel disease, lung infections, etc.
Usually elevated with other tumor markers to aid in the diagnosis of malignancy.
05
Carbohydrate antigen 19-9 (CA19-9)
This is a tumor-associated antigen of the digestive system. A mild increase in this indicator can be seen in gastrointestinal inflammation, and a significant increase may be related to the occurrence of gastrointestinal tumors, such as gastric cancer, colorectal cancer, gallbladder cancer, especially the highest sensitivity to pancreatic cancer.
06
Cytokeratin (CYFRA21-1)
This is a commonly used tumor immunohistochemical marker. CYFRA21-1 expression is seen in patients with both squamous cell carcinoma and lung adenocarcinoma, particularly in lung squamous cell carcinoma.
07
Carbohydrate antigen 242 (CA242)
This tumor marker is also commonly used in the diagnosis of tumors of the digestive system, such as stomach cancer, colorectal cancer, and pancreatic cancer. The positive rate is higher for combined diagnosis with other tumor markers.
08
Carbohydrate antigen 15-3 (CA15-3)
30% to 50% of breast cancer patients have a significantly elevated CA15-3, but the sensitivity to early breast cancer is not high enough.
Elevated CA15-3 is also seen in other malignant tumors, such as lung cancer, stomach cancer, colon cancer, ovarian cancer, etc.
09
Carbohydrate antigen 125 (CA125)
A specific marker of ovarian cancer, serum CA125 is elevated in 80% of patients with ovarian epithelial malignancies. When ca125 values are 2 times higher than normal and above the risk of ovarian cancer should be noted. However, half of patients with early-stage ovarian cancer do not have a high indicator.
Will these programs definitely detect cancer?
First of all, it is necessary to make it clear: tumor markers are abnormal≠ cancer.
Certain inflammation, smoking, and even pregnancy status may cause small increases in some tumor markers. However, if some indicators increase significantly and hundreds of times higher, they need to be more vigilant and further screened.
Second, a normal tumor marker does not necessarily mean that there is no cancer.
Because each test has sensitivity and specificity issues, cancer cannot be screened for 100%. In this regard, many doctors have controversy about the need for tumor marker screening during physical examination, but most doctors still support tumor marker screening, especially people over the age of 45.
Sensitivity: Used to describe the ability of the test not to miss the real patient.
Specificity: used to describe the ability of the test not to misjudge the disease of a normal person.
Tumor markers or imaging?
Do tumor markers detect tumors earlier than imaging tests?
The smallest tumor that can be found on general ultrasound and CT examination is about 5 mm, and before that, tumor markers usually have abnormalities, so tumor marker detection is of great significance for early diagnosis and prevention of tumors.
How to make better use of tumor markers?
In fact, the combination of tumor markers is far more helpful for diagnosis than the abnormality of a single index, which can greatly improve the accuracy of diagnosis. Common combinations are as follows:
Tumors of the digestive tract
CEA+CA242+CA199+CA724; screening recommends adding gastroscopy, colonoscopy, and ultrasound.
lung cancer
Non-small cell lung cancers usually have elevated CEA and CYFRA21-1; small cell lung cancers usually have significantly elevated NSE (neuron-specific enolase); screening recommends low-dose spiral CT.
breast cancer
CEA +CA125+CA153; breast molybdenum targets are recommended for screening.
Cervical cancer
CEA +CA125; Screening recommends a combination of HPV testing plus cervical TCT.
Ovarian cancer
CEA +CA125+AFP+HCG (human chorionic gonadotropin); screening recommends increased ultrasound.
Many people go through the formalities during the physical examination of the unit, and some unit physical examination items are often not comprehensive enough, so that the physical examination is normal every year and the advanced cancer is suddenly detected.
In fact, we can grasp each physical examination, according to their own situation (such as family history, bad living habits), as appropriate, increase the need for examination items, the emergence of disease in time to kill.
Source: U.S.-China Jiahe Cancer Prevention
Edited by: Yeah Reviewer: Xiao Ran