Discovered in 1978, tumor markers can be detected in the tumor-related substances in the blood, body fluids and tissues, and to a certain level, they can reflect the presence of certain tumors.
Serum Tumor Marker Classification:
1 Carcinoembryonic antigen (CEA) Found in 1965, CEA can be described as the most broad spectrum of indicators, as its rise can be seen in the colorectal cancer, stomach cancer, lung cancer, pancreatic cancer, breast cancer, ovarian cancer, uterus and cervical cancer, urinary tract tumors, and other malignant tumors with different degrees of positive rate. In short, CEA is most likely to rise in adenocarcinoma, followed by squamous cell carcinoma and poorly differentiated carcinoma. When there is a late tumor stage, loaded tumor, or tumor metastasis, there will be increased CEA.
2 Alpha-fetoprotein (AFP) AFP is an ancient but excellent tumor marker, whose specificity in primary liver cancer is very high, with the positive rate of 70%. If a patient has a history of hepatitis B, and has liver mass, with AFP> 400ng / ml and for 1 month, he can be diagnosed as liver cancer. In addition to liver cancer, AFP will also be elevated in endodermal sinus cancer, teratoma, testicular cancer, ovarian cancer, gastric cancer with liver metastases. The vast majority of viral hepatitis/cirrhosis patients will also see AFP increase, but it will not over 400ng / ml. Women AFP begin to rise after pregnancy for 3 months and reach the peak during 7 to 8 months, and 3 weeks after delivery it’ll return to normal level.
3 Carbohydrate antigen 125 (CA125) The most important clinical significance of CA125 is to reflect the ovarian cancer, with positive rate of 61.4%, and CA125 is a good indicator of the treatment efficacy and recurrence of ovarian cancer. If the treatment is effective, the CA125 will decline, and once recurrence occurs, CA125 will be elevated before the symptoms.
4 Carbohydrate antigen 15-3 (CA15-3) CA15-3 has great clinical significance in the diagnosis of breast cancer. In the early stage of breast cancer, the sensitivity is low, 30%, but in the late stage, the sensitivity is up to 80%, which has important value in the efficacy, prognosis, recurrence and metastasis diagnosis of breast cancer. Other malignant tumors also have a certain positive rate, and in the liver, gastrointestinal tract, lung, breast, ovarian and other non-malignant tumor disease, the positive rate of less than 10%.
5 Carbohydrate antigen 19-9 (CA19-9) CA19-9 is an important indicator of digestive system tumors. In pancreatic cancer, gallbladder carcinoma and cholangiocarcinoma, CA19-9 is significantly increased, especially in pancreatic cancer the positive rate is 75%.
6 Carbohydrate antigen 242 (CA242) The clinical application of CA242 is relatively less, and it is significantly increased in adenocarcinoma, while in non-squamous tissue the level of CA242 is higher than that of squamous cell carcinoma. CEA, together with CA242 can improve the detection sensitivity of adenocarcinoma. CA242 is used as a escalator of CA19-9, as its sensitivity is similar to that of CA199 in pancreatic cancer and cholangiocarcinoma, but its specificity is better than that of CA199, which was less affected by benign diseases such as pancreatitis, hepatitis and cirrhosis. In colorectal cancer, its sensitivity is up to 60% to 72%.
7 Prostate specific antigen (PSA) PSA is the most specific indicators of the prostate, the positive rate can be as high as 50% to 80%, but in prostate hyperplasia, prostatitis, kidney and urogenital diseases, PSA can also be seen increased.
8 Nerve specific enolase (NSE) Small cell lung cancer is the most sensitive and the most specific tumor markers. In neuroendocrine tumors increased significantly, such as: pheochromocytoma, medullary thyroid carcinoma, melanoma, islet cell tumor. It should be noted that the value of NSE is very unstable, and hemolysis will lead to elevation.
9 Carbohydrate antigen 50 (CA50) CA50 is also a very broad tumor marker, and in liver, lung, stomach, knot / rectum, pancreas, gallbladder, kidney, uterus, ovary, breast, bladder, prostate cancer, lymphoma, melanoma pneumonia, nephritis, pancreatitis, colitis and other infectious diseases, it will also increase. In addition, some ulcerative disease, autoimmune diseases also make CA50 rise.
10 Carbohydrate antigen (CA72-4) The positive rate of CA72-4 can reach 65% to 70% in gastric cancer, higher in patients with transference. In the colorectal cancer, pancreatic cancer, liver cancer, lung cancer, breast cancer, ovarian cancer, CA72-4 with a certain positive rate can be used as an important indicator in cancer treatment follow-up, recurrence and prognosis.
11 Cell keratin fragment antigen 21-1 (CYFRA21-1) The best indicator to detect lung cancer. If the lungs have no clear ring shadow, while serum CYFRA21-1 concentration> 30ng / ml, there is a high possibility of lung cancer. Early diagnosis of lung cancer once found CYFRA21-1 increased, it can be used as an important indicator of the prognosis of lung cancer.
12 Tissue peptide antigen (TPA) TPA consists of cell keratin proteins 8, 18 and 19, and can directly reflect the degree of cell proliferation, differentiation and tumor infiltration. Patients with lung cancer will have increased TPA, whose sensitivity is close to CYFRA21-1, with quite positive rate of about 61%. In bladder cancer, prostate cancer, breast cancer, ovarian cancer and gastrointestinal malignancies, TPA will be increased; acute hepatitis, pancreatitis, pneumonia and gastrointestinal diseases and 3 months after pregnancy can also see TPA increased.
13 Squamous cell carcinoma antigen (SCCA) Specific marker for Squamous cell carcinoma. It is used for the diagnosis of squamous cell carcinoma, cervical cancer, lung cancer, head and neck cancer, as its concentration increased with the condition increased. Its increase can also be seen in hepatitis, cirrhosis, pneumonia, tuberculosis and other benign diseases.
14 Human epididymal secretory protein 4 (HE4) HE4 is a very good tumor marker for the diagnosis of ovarian cancer with a sensitivity of 72.9% (above CA 125) and a specificity of 95%. CA125 + HE4 is the best combination for the diagnosis of ovarian cancer.
15 Free-β-HCG It is the most sensitive indicator for Germ cell cancer, especially for choriocarcinoma, with sensitivity up to 100%. If people have block on the liver along with the AFP increase, then there is a high degree of primary liver cancer; if Free-β-HCG is increased, then it is suspected as germ cell cancer. Free-β-HCG increase also suggests a high degree of malignancy, poor prognosis.
16 Ferritin (Ft) Ft is associated with a variety of tumors, but is not a direct evidence of the tumor. When there is blood transfusion, iron therapy, aplastic anemia, hemolytic anemia, thalassemia, primary hemosiderosis, connective tissue disease, a variety of liver disease and chronic renal failure, infectious diseases, the Ft level will increase, while the patients with iron deficiency anemia will appear Ft decline.
Screening of tumor markers
No tumor markers can achieve 100% accuracy, and a tumor marker may also be associated with a variety of tumors, so in clinical we often use a coordinated screening method. Creative Diagnostics provides tumor markers elisa kits for the screening of tumor markers.
|Type||Combined Detection Method|
|Stomach cancer||CEA、 CA724、 CA19、CA50、CA242|
|Can not determine the pathological type of cancer||CEA+NSE+CYFRA21-1+CA125|
|Small Cell Lung Cancer||CEA+NSE|
|Squamous cell carcinoma||CYFRA21-1+SCC+TPA|
|Large cell lung cancer||CYFRA21-1+CA125+TPA|
Tumor markers increase do not necessarily indicate cancer; some tumors do not secrete related proteins, so the tumor markers can not rule out the normal tumor. Reasonable application, timely monitoring, is the clinical application of tumor markers in the correct way.