Elevated carcinoembryonic antigen, is it cancer?

For two weeks, Chen had not had a good night’s sleep and had been tormented by the word “tumor” in his mind.

Two weeks ago, the unit’s physical examination showed that the tumor markers CEA and CA199 were both elevated, which frightened Chen. “The elevated tumor markers, does that mean the body has a tumor?”

In addition, during those days, Chen did not feel well, his stomach would ache from time to time, and he did not eat properly because of his busy work.

After finishing the work, Chen hurried to the outpatient department of the hospital for consultation, but the doctor comforted her: “Don’t scare yourself young people first, the tumor markers are not necessarily cancer, but also need further examination, I suggest you do a gastroscopy first.”

At the doctor’s suggestion, Chen underwent gastroscopy, and the results showed that there were indeed several polyps in his stomach, but no tumor was found. The polyps were also removed under the microscope at the moment, and only follow-up observation was needed, and there was no serious problem.
Chen was relieved, but at the same time, she wondered: Why pay for a test when tumor markers can’t diagnose cancer?
Check out the result is wrong, is not oneself frighten oneself?

1. What are tumor markers?

Tumor marker (TM) is a kind of substance synthesized by tumor cells or raised in response to tumor cells. Its components mainly include proteins and sugars.
Tumor markers are widely found in cells, tissues, blood or body fluids. They are some indexes of the human body, which can be detected by biochemical and immunological methods, and can reflect the occurrence and development of tumors, or monitor the response of tumors to treatment.

Many people think they have cancer when their tumor markers are elevated during a physical examination, but in fact, there is no tumor marker that can definitively diagnose or rule out a tumor.
For example, in the case of Xiao Chen, her CEA and CA199 were both elevated, but it was not because of cancer, but because of a polyp growing in her stomach.

In fact, in addition to cancer, elevated levels of CEA, or serum carcinoembryonic antigen, can be caused by smoking, ulcerative colitis, pancreatitis, colon polyps, active liver disease, and other conditions.
Although the carbohydrate antigen CA199 is suitable for the diagnosis of pancreatic cancer, the value of CA199 may also be increased due to benign diseases such as acute pancreatitis, biliary stone, cholangitis and non-cancerous liver diseases.

Therefore, it is a great error to judge whether one has cancer simply by increasing the value of tumor markers, and other examination means are needed to be combined for diagnosis.

So, one might ask, why pay for a test when you can’t diagnose cancer?
Isn’t it a waste of money?
In fact, although tumor markers cannot diagnose cancer, they are still an important physical examination item. This is mainly because the clinical testing of tumor markers can be used in the following three ways:

1. It can be used for general examination and screening of tumors to assist in judging whether there is a tumor.
   Early detection and early treatment are the basic principles of tumor treatment.
   Tumor markers are important clues to finding tumors in people at high risk of cancer.
   If the data is abnormal, patients can do other tests according to the actual situation in time to help detect early tumors, timely treatment, and improve the survival rate;
2. After surgery, radiotherapy and chemotherapy for cancer patients, the therapeutic effect can be monitored by tumor markers.
   In general, if the tumor is completely removed and the treatment is good, the number of tumor markers goes down.
3. Dynamic monitoring of tumor markers is helpful to determine whether the tumor has recurred and determine the next treatment plan;
   In addition, the increase or decrease of tumor marker concentration is closely related to tumor prognosis.

Third, the tumor markers corresponding to common cancers should be vigilant when the value is abnormally high

Generally speaking, the tumor markers that are tested by drawing blood in hospitals are mainly for liver cancer, lung cancer, prostate cancer, colorectal cancer and so on.
If abnormal values of the following tumor markers are found, the alert should be raised:

1, liver

Alpha-fetoprotein (AFP) is mainly used in the diagnosis of primary liver cancer, but increased AFP can also be caused by hepatitis, cirrhosis, and pregnancy.
If AFP is more than 400ng/mL and lasts for 4 weeks, pay attention.
If the AFP value is 200~400ng/mL for 8 weeks, it is a relatively dangerous situation, which needs to be further examined in combination with imaging to determine whether the patient has liver cancer.

2, lung cancer,

Cytokeratin 19 fragment (CYFRA21-1) is commonly used to detect lung cancer.
When CYFRA21-1 & gt;
When 30ng/ml, be alert to lung cancer.
In general, the positive detection rate of non-small cell lung cancer is 70%~85%, and the positive rate of carcinoembryonic antigen (CEA) for the diagnosis of lung cancer is about 50%.
In addition, neuron-specific enolase (NSE) may assist in the diagnosis of small cell lung cancer.

Prostate cancer

Prostate specific antigen (PSA) is used to diagnose prostate cancer.
If found PSA>
At 10ng/mL, the risk of prostate cancer is increased and further tests should be done as soon as possible.

4. Colorectal cancer

If the CEA exceeds 20ug/L, it is often indicative of a digestive tract tumor.
In addition, CA199, CA724 and CA242 make up for the deficiency of CEA to a certain extent.

5. Ovarian cancer

Glycosylated antigen 125 (CA125) is used to diagnose ovarian cancer.
If discover the CA125 & gt;
35U/mL, there may be ovarian malignant tumor;
However, when CA125 exceeds >;
70U/mL, it is highly suspected to be due to malignant tumor.

6. Breast cancer

The value of CA15-3 increased, and the sensitivity for early breast cancer was 60%, and the sensitivity for late breast cancer was 80%.
In addition, CEA, CA125 and other tumor markers are complementary indicators for the diagnosis of breast cancer.

Four, in life, in addition to the physical examination, we should also pay attention to the abnormal signals sent by the body

In recent years, the incidence of cancer in China is still on the rise.
Cancer has an incubation period of 10 to 20 years and is not easily detected in its early stages.
In daily life, in addition to regular physical examination, we should also pay attention to abnormal signals sent by the body, such as:

1. Mass appears on the body surface and increases rapidly in a short period of time;

2, warts and moles rapidly increase or rupture;

3. Weight loss for no reason or long-term unexplained fever;

4, often appear nasal obstruction, nasal suction back blood;

5, feel chest discomfort when swallowing, swallowing difficulty or a sense of choking.

6, persistent cough, sputum with blood;

7. Prolonged ulcer or persistent digestive abnormality;

8, urine and feces habits change, blood in urine, blood in stool;

9. Irregular vaginal bleeding occurs in women after the end of menstruation or menopause;
10. Persistent headache, blurred vision and so on.

Five, want to diagnose cancer, still have to carry out what kind of test?

There is no inevitable relationship between tumor markers and cancer. If the value of tumor markers is found to be elevated, other tests, such as ultrasound examination, nuclear magnetic resonance examination and pathological examination, should be performed according to the actual situation in order to diagnose cancer.

As mentioned above, the most important marker for primary liver cancer is AFP.
When the AFP value increases, in order to determine whether there is cancer, ultrasound B-ultrasound examination can be performed to see if there is any tumor, and to check the size and growth site of the tumor.
Second, an MRI examination can be performed to determine the primary lesion.
In addition, if a tumor is found, a biopsy is performed to determine whether the tumor is benign or malignant.

For cancer such as lung cancer, stomach cancer and cervical cancer, chest radiographs, gastroenteroscopy, gynecological examinations and Pap scrapes are required respectively.

Finally, remember the cancer associated with the various tumor markers.
Don’t scare yourself if you find an abnormal number of tumor markers on your checkup.
Generally speaking, people at high risk of cancer, such as those with a family history of cancer, are at higher risk of cancer and need to identify cancer through methods such as ultrasound.
Ordinary people talk to their doctor, and then decide whether to do other tests based on the actual situation.