CEA - let adenocarcinoma nowhere to hide
For tumor-related related examinations, it is necessary to take blood to check tumor markers, which shows its importance. The CEA (carcinoembryonic antigen) index is quite meaningful.
We had a patient to see a doctor some time ago. Male, 65 years old, had no other symptoms. The physical examination found that CEA was particularly high, up to one or two hundred, and the normal value was below 5. I couldn't find other reasons. I did a whole-body PET-CT. I found a lymph node with a diameter of 4 cm on the side of the back of the superior vena cava. This lymph node is shiny on PET-CT. (Lighting means high metabolism of the tissue, and there may be tumors).
The patient made a mediastinum for a definitive diagnosis. He opened a 2 cm long mouth from the neck and extended a mirrored instrument. The lymph node on the side of the heart was taken out. The pathological return was lung. Adenocarcinoma.
CEA, the first indicator, as long as it is related to adenocarcinoma, it will rise, not only the primary lung, many of the intestinal cancer are adenocarcinoma, and the intestinal cancer CEA index will also increase. Second, the level of CEA is related to the prognosis. This patient's CEA has decreased after chemotherapy, indicating that the drug is used and the tumor is controlled. If the CEA is still going up after chemotherapy, it is possible that the tumor can not be controlled and the prognosis is not good, so this indicator is quite useful. The tumor marker CEA ranks first, and it is the most effective. Once it is raised, it must be vigilant. If it is increased by more than 3 times, it is generally considered to have adenocarcinoma. If the original lesion cannot be found, this situation must be done. Whole body PET-CT to further confirm the diagnosis.
AFP - alarm for liver cancer diagnosis
There is also an AFP (alpha-fetoprotein), and many patients with liver cancer have AFP higher than 1000.
There are at least one hundred million people in China's hepatitis B virus, that is, one in 10 people. 10% of these people will develop cirrhosis in the future, which will eventually lead to liver cancer. Then how to judge whether these people will have liver cancer, the detection of two indicators, one is B-ultrasound, according to the treatment standards of developed countries such as Japan, three months to six months to do a B-ultrasound, see if there is any liver in your Placeholder, the second is the AFP indicator, AFP suddenly rises, it suggests the possibility of liver cancer.
For example, this patient is a carrier of hepatitis B virus, a high-risk group of liver cancer, if regular B-ultrasound and AFP detection, when liver cancer is very small, you can find it, you do not have to open a large mouth to cut the liver, only need radiofrequency ablation Yes.
Radiofrequency ablation is to put a needle into the liver tumor under the guidance of B-ultrasound. This needle is like a small umbrella. The front is opened like a dandelion. Radiofrequency treatment is like a microwave oven, emitting high-frequency rays. We burned all the surrounding and surrounding 50px tissues and burned the tumor completely.
NSE - Compass for the treatment of small cell lung cancer
Lung cancer is mainly divided into two major categories, small cell lung cancer and non-small cell lung cancer. The prominent oncological marker of small cell lung cancer is NSE, also known as neuron-specific enolase, because small cell lung cancer cells contain a large number of neuroendocrine particles. Can cause a significant increase in NSE in the blood. The treatment options for small cell lung cancer and non-small cell lung cancer are completely different. Small cell lung cancer is equivalent to a medical disease. The main treatment is radiotherapy and chemotherapy, and the chemotherapy effect is very good. Therefore, this indicator is very useful for the treatment of lung cancer. Guiding significance.
If the patient has a central type of lung cancer and the NSE is particularly high, then this patient should not consider surgery. First, take a pathological look. If it is small cell lung cancer, do chemotherapy and radiotherapy quickly, and the treatment effect on small cell lung cancer can also be The dynamic changes in NSE were combined with the results of CT to evaluate.
CA199 - Targeting pancreatic cancer and other indicators, such as CA199, the most common is pancreatic cancer, pancreatic cancer CA199 can be greater than 1000, but some lung cancer patients also have this indicator, like a lung cancer patient I recently managed , CA199 reached 1300. Therefore, tumor markers are very important for the discovery and prognosis of tumors. The CEA, CA199, AFP and NSE mentioned earlier should be routinely performed. It is generally considered that as long as it exceeds the normal value by more than 3 times, it has clinical significance. Of course, many very early tumors, although tumors are found in CT or B-mode ultrasound, these markers may not have increased, but the existence of tumors cannot be denied.
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