What does elevated tumor markers mean? CEA (tumor marker): indicators, norm, interpretation

It has increased in our country. This is especially observed in regions with developed industrial sectors.

In women, a large number of cancer pathologies occur in the organs of reproduction, digestion and respiratory system. It is not always easy to identify a disease using instrumental methods, therefore, if they suspect it, oncologists send you to donate blood.

Concept

These are substances produced by organs in response to cancer invasion.

Their presence allows us to suspect the development of a tumor at an early stage. This increases not only the chances of successful healing, but also prevents the possibility of developing metastases.

Protein substances are produced not only by diseased tissues, but also by some healthy ones. Therefore, several tests are often prescribed at once.

More than 200 types of markers are known in medicine, but only twenty are used to make a diagnosis. Today the rule is: the earlier they are identified increased performance protein compounds, the more successful the treatment will be.

The peculiarity of tumor markers is that they are present in small quantities in the blood of almost everyone.

Doctors say that sometimes their number increases when benign formations. If the indicators are very high, then most likely we're talking about about the development of metastases.

Timely research allows:

• identify risk groups,
• indicate the place where malignant cells are localized,
• evaluate the results of treatment,
• monitor impact.

What tumor markers should women be tested for?

Women's bodies produce hormones, the levels of which increase as cancer develops.

Usually, if there is a suspicion, a doctor will refer you for a blood test to identify tumor markers:

• – reveals, hearing organs and.
• – increases with formations in.
• – appears when , .
• – identifies oncology of the ovarian system.

Some antigens detect cancer but do not determine its location. In these situations, additional examination using X-rays and ultrasound is prescribed. These include: CEA, hCG, AFP.

The latter increases when fetal developmental defects are suspected. Its elevated levels indicate Down syndrome, problems associated with the formation abdominal wall or neural tube.

How to take a blood test for tumor markers?

Blood collection from women occurs from a vein. To increase the reliability of the results obtained, it is recommended to conduct the study on an empty stomach, in a sitting or lying position.

Approximately three days before the appointed time, it is recommended not to drink alcoholic beverages or eat fatty foods. It is worth limiting physical activity. On the day of the examination, it is better not to smoke or take medications.

To monitor the course of the disease, blood is donated frequently, depending on the affected organ, the prescribed treatment, once every 10 days or after three months. Properly prescribed treatment shows a decrease in the concentration of antigen in the blood.

If carried out surgery, then blood is donated frequently to determine whether additional chemotherapy or radiotherapy is needed. When saving low level Markers can indicate that cancer cells have been completely removed.

Normal indicators

Indicators may differ slightly and be outside the normal range. Therefore, doctors talk about three types of results: normal, borderline state and pathology.

Indicators below this mark are considered normal:

A slight increase in these indicators is observed when inflammatory diseases, for benign tumors and cystosis.

There are also specific requirements for women. For example, when donating blood for PSA, you should abstain from sexual intercourse.

CA 125 is a protein synthesized by the endometrium of the uterus. Therefore, its concentration changes during the menstrual cycle.

Alpha protein levels may be increased in pregnant women, and carcinoembryonic antigen levels in smokers. Therefore, before taking the test, be sure to give the doctor complete information about yourself.

Affects the level and age of the woman. During menopause, a hormonal imbalance occurs, slowing down metabolic processes. Therefore, during this period, research becomes less reliable. The oncologist usually prescribes repeated confirmation of the results.

Regardless of which tumor marker was studied, the results are ready within a day to a week.

This mainly depends on where the biomaterial was collected. If in a regular clinic, the waiting period increases. Today there are many throughout the country medical laboratories who will be able to provide results the next day.

How much does the analysis cost?

First, decide where you will get tested. The future depends on it.

The doctor will tell you how many tumor markers you need to test for. This is determined on a case by case basis.

You can take it for free at the oncology center if indicated. They are in every major city.

They also donate blood in laboratories. When choosing, pay attention to the availability of licenses.

The cost of tumor markers for women is usually the same as donating blood for alpha-fetoprotein, a cancer embryonal marker. Depending on the type of marker being determined, the price varies from 500 to 2500 rubles.

In conclusion, we note that an elevated level of tumor markers does not indicate the presence of cancer. In such a situation, you should first weigh what led to false result, and only then donate blood.

The study is scheduled again after about three months.

To confirm the diagnosis, MRI is prescribed, endoscopic examinations And . Only on the basis of a set of measures taken will the doctor make a diagnosis.

The statistics are inexorable - the incidence of cancer throughout the world is growing every year. There are a huge number of reasons for this - this is the general deterioration of the environmental situation, the spread bad habits(smoking, alcohol), eating carcinogens or using them in everyday life, aging population, etc. There is also a tendency towards a decrease in the average age of patients; cancer is “getting younger”. Fortunately, medicine does not stand still; oncology is currently one of the priority areas. Modern technologies make it possible to diagnose cancer at the earliest early stages, which means significantly increasing the likelihood of cure. One of the most effective ways Diagnosis of oncological diseases currently involves analysis of tumor markers.

What are tumor markers

Tumor markers are special proteins that are found in the blood or urine of cancer patients. Tumor cells produce and release tumor markers into the blood from the moment the tumor appears, which makes possible diagnostics diseases in the early stages.

Tumor marker analysis is not only one of the most reliable ways to detect a malignant tumor, but also an opportunity to evaluate the effectiveness of the treatment. Relapse of malignant diseases can be predicted several months before the onset clinical manifestations. Due to the specificity of each protein, the site of the disease can be predicted.

Deviation from the norm of some markers clearly indicates damage to certain organs (PSA, sPSA); other tumor markers can be detected at different tumor locations. In this case, it is advisable to comprehensive examination. Unfortunately, this is why cancer diagnosis based on tumor marker analysis alone is not reliable.

Tests for tumor markers

Each neoplasm secretes a strictly defined protein. About 200 compounds related to tumor markers are known, but no more than 20 of them have diagnostic value. Tests for the following types tumor markers.

Tumor marker AFP (Alpha Fetoprotein)

Tumor marker B-2-MG (Beta-2-microglobulin)

The tumor marker Beta-2-microglobulin can be found in all cells except red blood cells and trophoblast cells.

Normally, Beta-2-microglobulin is detected in urine in very small quantities.

An increase in blood concentration may indicate renal failure.

The level of this marker is associated with the activity of the immune system and can increase with any inflammatory disease.

A test for Beta-2-microglobulin is prescribed for suspected

• B-cell lymphocytic leukemia,
• lymphomas.

Tumor marker PSA (prostate specific antigen), sPSA (free prostate antigen)

PSA is present in healthy, overdeveloped and transformed prostate tissue. This is the most specific and sensitive antigen for diagnosing prostate cancer.

For research, blood (serum or plasma) is taken before biopsy, removal or massage of the prostate, because Mechanical irritation of the gland can cause an increase in PSA levels that lasts up to 3 weeks.

The PSA norm is 0-4 ng/ml, a level of 10 ng/ml and above indicates a malignant disease. At a PSA level of 4-10 ng/ml, it is advisable to determine sPSA.

The ratio of sPSA concentration to PSA concentration, expressed as a percentage, has diagnostic value:

• Malignant tumor: 0-15%
• Borderline values: 15-20%
• Benign disease: 20% and above

Tumor marker CEA (carcinoembryonic antigen)

The tumor marker CEA is produced by cells during pregnancy digestive tract fetus In adults, synthesis is almost completely suppressed.

The CEA level is normal - the content in the blood is no more than 0-5 ng/ml.

CEA levels increase in malignant diseases:

• stomach
• colon
• rectum
• lungs
• mammary glands
• ovaries
• uterus
• prostate

Some increase in the CEA tumor marker is possible in chronic renal failure, hepatitis and others. chronic diseases liver, pancreatitis, in smokers, as well as in patients with tuberculosis and autoimmune diseases.

Tumor marker CA 125

CA 125 is a standard tumor marker for ovarian cancer. Normally, the concentration of the tumor marker CA 125 in the blood is 0-30 IU/ml.

Increased level CA 125, more than 35 IU/ml may indicate malignant diseases:

• ovaries (mainly),
• uterus (inner layer - endometrium),
• mammary gland.
• pancreas (in combination with CA 19-9)

Increased concentrations of CA 125 are found in women with endometriosis and adenomyosis (diseases in which the cells lining inner surface uterus, are found in other parts of the body). Physiologically, an increase is observed during pregnancy and during menstruation.

Tumor marker CA 15-3

Tumor marker CA 15-3 is a specific tumor marker for breast cancer.
Normally, the level of CA 15-3 is 0-22 U/ml.

A concentration above 30 IU/ml indicates pathology. In 80% of women with metastatic breast cancer, the level of the marker is elevated.

Tumor marker CA 15-3 is effective in determining relapses. Some elevation of the marker may also occur during pregnancy.

Tumor marker CA 19-9

A blood concentration of 40 IU/ml or higher is considered pathological. CA 19-9 is used in diagnosis and treatment monitoring:

• pancreatic cancer,
• stomach cancer,
• colon cancer,
• rectal cancer
• gallbladder cancer

Tumor marker CA 242

It is found in the same cases as CA 19-9, but has a higher specificity, allowing it to detect pancreatic, colon and rectal cancer at the earliest stages.

This is one of the main markers used in diagnosis. Based on the results of the analysis of this tumor marker, it is possible to predict the recurrence of malignant diseases gastrointestinal tract in a few months.

The normal values ​​of tumor marker CA 242 are 0-30 IU/ml.

hCG (human chorionic gonadotropin)

A hormone that normally increases during pregnancy to protect the fetus from immune system mother.

An increase in hCG in men and non-pregnant women indicates malignant growth.

HCG norm value: 0-5 IU/ml, values ​​above 10 IU/ml are observed in trophoblastic tumors, chorionic carcinoma of the ovary or placenta (most sensitive), testicular cancer.

UBC (Urinary Bladder Cancer)

Cancer marker Bladder. A highly specific test, effective in the early stages. UBC is determined in urine that has been in the bladder for at least 3 hours; the level of 0.12*10 -4 µg/µmol is considered normal; with malignant lesions of the bladder, the concentration increases to 20.1-110.5*10 -4 µg/ µmol

It must be taken into account that one tumor marker may appear when various diseases, therefore for accurate diagnosis use a combination of markers. For example, when defining

• stomach cancer - REA and CA 242,
• pancreas - SF 242 and SA 19-9,
• testicular cancer - AFP and hCG.
• a simultaneous increase in the tumor markers CA 19-9, CEA and AFP indicates liver metastases.

Another subtlety is that elevated levels of tumor markers do not necessarily mean cancer. Therefore, biochemical studies must be supported by clinical ones.

To be able to determine whether a person’s tumor is benign or malignant, special samples of blood, urine and other fluids are needed. This is how tumor markers are determined. Each type has its own degree of reliability, for this reason the doctor may prescribe several types of tests. What a blood test for tumor markers shows can only be determined by a specialist in this field.

Tumor markers are a cluster chemical substances. They can be formed both by healthy cells in the body and by those that already have pathology. With the help of such tests, you can detect a terrible disease already in the initial stages.

They can be released by the tissues themselves, as well as by tumors that are located next to them.

The substances are different types. This directly depends on their structure.

1. Antigens.
2. Blood plasma proteins.
3. Substances that affect tumor decay.
4. Enzymes that are formed during the metabolic process.

The only difference is their specificity. They are distinguished by composition. In other words, different substance indicates in different forms tumors.

How and when tumor markers were discovered

The year when tumor markers were discovered is considered to be one thousand eight hundred and forty-five. It was in this year that a specific protein was discovered, called Bence Jones. The doctor who discovered this type protein in his urine, he was still very young and only showed hope for a bright future. Bence-Jones was then working at a London hospital. It was during these years that the science of immunology made its greatest breakthrough, and as a result, many more types of such proteins were identified, and over time they received the name tumor markers.

Indications for tumor marker studies

They have many types. Some can detect cancer only at an early stage. And there are those that can only be used for monitoring. But all markers are used to monitor the treatment being carried out and to find out how quickly the recovery process is proceeding.

Important! And after a complete recovery, doctors oblige you to take an analysis for tumor markers, because you can miss the development of relapses.

There are many such indicators that are not used for screening, which is why in a large number of cases they will be suitable for monitoring to check whether the treatment prescribed by the doctor is helping. But there is also an accurate tumor marker - PSA. Only its use is possible for preliminary analyzes about the state of organs.

What types of tumor markers are there?

Markers have properties that vary according to for various reasons. The main one is highly sensitive and specific. But there is also minor species. They are used together with the main ones and together give a result that is more accurate. Additional is used to determine relapse.

This substance is divided according to its origin:

• receptors;
• hormones;
• enzymes;
• oncofetal.

Oncofetal diseases are usually classified as large quantity oncological indicators. Such structures are found in huge quantities only in embryonic tissue; they play a very important role important role in the formation of a child. For an adult, this amount should be as small as possible. Enzymes come second in the significance column.

There are also tumor markers that help find the location of the tumor.

1. Chest – CA15-3, CEA.
2. Testicles – VHCG, AFP.
3. Ovaries – CA125, CA19-9.
4. Uterus – CA 19-9, CA 125.
5. Liver –AFP.
6. Intestines – CA 19-9, CA 125.
7. Leather – S 100.
8. Prostate gland – PSA.
9. Bladder – TPA, Cyfra 21-1.
10. Pancreas – CA 19-9, CA 72-4.

Some of the indicators may exceed the norm. But it is difficult to accurately determine the presence of cancer from them. For example, CEA is produced in the tissue of the embryo, and is present in small quantities in an adult; it is he who is sensitive to a large number oncology.

Marker standards that are most often determined

After you have taken a blood test for tumor markers, you need to know which indicators are within normal limits.

1. – up to 3 ng/ml.
2. AFP – up to 15 ng/ml.
3. CA 19-9 – up to 37 units/ml.
4. CA 72-4 – up to 4 units/ml.
5. CA 15-3 - up to 2 units/ml.
6. CA 125 – up to 35 units/ml.
7. SCC – up to 2.5 ng/ml.
8. NSE – up to 12.5 ng/ml.
9. CYFRA 21-1 – up to 3.3 ng/ml.
10. HCG – 0-5 IU/ml (in men and non-pregnant women).
11. PSA – up to 2.5 ng/ml (in men under 40 years old), up to 4 ng/ml (in men over 40 years old).
12. b-2 microgranules – 1.2-2.5 mg/l.

Tumor detection technique

Any tumor, no matter what it is, tends to produce a special protein in the body, which will be shown by a blood test for tumor markers. Detection is only possible when body fluids are examined.

For example, AFP will help predict cancer of the breast, liver, kidneys, testicles, and ovaries. But the indicator may also be increased due to liver pathologies, as well as kidney pathologies. If a woman is pregnant during this period, then these ailments can affect the health of the unborn child or cause defects in the fetus. In order to conduct the study, you need to take amniotic fluid, ascitic fluid, and blood.

Very often, it is in blood and urine that it is possible to isolate a marker through very complex chemical experiments carried out exclusively in laboratory conditions. The results may be obtained from your doctor.

Tumor markers that must be taken annually for cancer prevention

A blood tumor marker test can help detect cancer before symptoms appear. Typically, indicators can increase six months before the moment when metastases begin to appear. Every year it is necessary to check the health of only those who are on the list of those at risk of getting sick, that is, those most susceptible to this disease.

Men over forty years of age need to especially monitor this problem and be sure to donate blood for PSA, he will be able to recognize it. Slightly elevated may indicate benign tumor, and those that greatly exceed the norm are malignant. The doctor may also prescribe an additional hCG test. Other markers are not used for routine examination.

1. To check the gastrointestinal tract.

CA 15-3 can be prescribed only if there are problems with the gastrointestinal tract. Persons over 50 years of age fall into the category age groups, Where high risk earn oncology.

1. Examination thyroid gland.

It is thyroglobulin that should be tested to detect pathology. Large cluster it may indicate that there are no or present metastases in the body. Or that there are thyroid cells in the body.

The level of calcitonin indicates the size: how much the tumor has grown and how rapidly it is developing.

1. Liver diagnostics.

AFP - in half of the people taking the test, the test results increase 3 months before manifestation initial symptoms. To confirm the diagnosis, it is necessary to donate blood for markers such as CA 15-3, CA 19-9, CA 72-4, CA 242.

Attention! Indicators of a blood test for a tumor marker, which shows an excess of the norm, may also indicate oncology of other systems. It is for this reason that a more accurate result will be obtained only after another necessary diagnosis.

1. Lung check.

In order to identify the disease, it is necessary to check the lungs for the presence of malignant cells in the body. If the quantity exceeds normal indicators, there is an undeniable reason to be examined for non-small cell lung cancer. NSE is also found in cells in the brain and nerve cells. And if there are exceeded indicators, this does not mean that. This may indicate leukemia or neuroblastoma.

1. Pancreas.

If a doctor suspects pancreatic cancer, he prescribes a blood test for the CA242 + CA19-9 marker. If you take only one CA242, it may increase due to pancreatitis, cysts or other formations. And for more exact result attributed to him. But CA19-9 can also be secreted in the bronchi, for this reason the doctor may also prescribe CA74-4. This marker is produced exclusively by epithelial cells.

1. Kidney research.

There is one metabolic marker - Tu M2-PK. This marker determines how aggressive the tumor is. What distinguishes it from other such cells is that it does not have a cumulative effect.

But also, exceeding the levels of this marker may indicate breast or gastrointestinal cancer.

1. Bladder.

UBC is considered the most representative. This enzyme is contained in protein and enters the blood. It shows oncology in the early stages in seventy percent of cases. To ensure the accuracy of the diagnosis, NMP22 is prescribed.

1. Lymph nodes.

Cancers that are located in the lymph node system contribute to an increase in 2-microglobulin. This antigen tends to increase with formations occurring anywhere in the body. The stage of oncology is determined by its indicator.

In order to make a diagnosis of brain oncology, it is necessary to take a blood test for 4 markers at once. Since such studies can be carried out exclusively in a complex.

1. Oncology of the skin.

S-90 and TA-90 will help tell you about this disease. The number of these markers may also exceed the norm due to the presence of metastases. These analyzes can provide especially extensive information in combination with other markers.

For example, for a very long time the marker that pointed to was not found. And the suspicion was caused by the fact that the skin was hardening and peeling.

1. Tests for bone cancer.

In this situation, TRAP 5b carries the most information. This marker is a kind of enzyme present in the body in quite different quantities. It can be present in the body of both men and women. Only a specialist can decipher the test results.

1. Tumor marker analysis for throat cancer.

To detect oncology in this area human body two types of markers are needed: CYFRA 21-1 and SCC. The first is a special protein compound that manifests itself in levels above normal. It is secreted in many types of cancer. The second is an ordinary antigen.

If there is throat cancer, then the SCC rate is above 60%. But these indicators also have high mark and for other diseases.

1. Adrenal glands.

In order to determine adrenal cancer, you need to look at the concentration of all hormones that are present in the blood and urine. In basic cases, the doctor prescribes blood donation for DEA-s.

Blood donation for four more markers can be added to the examination.

1. Women's oncology.

These markers include CA 125; they detect malignant cells in a woman’s ovaries. This indicator also exists in healthy women, but it is very small.

For breast cancer, CA15-3 and also MSA are prescribed. The latter is an antigen that allows us to identify malignant and benign diseases that are present in the female breast.

If the result showed cancer of the uterus, this is most likely the case. Because with this analysis there were no false positive results.

1. Tumor marker s100.

This marker can be used to monitor all extracellular and cellular reactions. Helps identify skin cancer.

Increased levels of this marker provide information that melanoma or other forms of cancer are present in the body.

Correctness of blood test for markers

For the indicator to be as accurate as possible, you do not need to eat fatty foods, exercise physical activity, do not drink alcohol for 3 days. Testing for tumor markers is almost always carried out on an empty stomach and only in the morning.

On the day when the blood test is scheduled, it is prohibited to smoke or drink any medications. Other factors may also affect the result, which is why you need to go and get checked by a doctor.

How long it takes to process the results is of interest to many patients who undergo tests. Many types of tumor markers can be determined in one or two days. But you can learn more directly from the laboratory assistant who accepts and performs the study.

If the patient needs the result very urgently, then a transcript of the analysis will be provided to the oncologist on the day of the test. Another situation may also arise. The laboratory may be in the wrong place medical institution where the patient is being treated, and in this case the result will need to be expected for about several days, and in very difficult cases week.

When can indicators be increased?

Even if tumor markers are elevated after donating blood, do not despair. Since their indicator can very often be influenced somatic diseases, inflammatory process in the body, as well as such a harmless disease as ARVI.

Tumor markers have the ability to identify good- and malignant tumors.

If a tumor is present in the body, but the marker values ​​are not very significant, then there is a possibility that it is benign. In oncology, the result can be more than ten times higher. Oncologists warn that the higher the marker indicator, the more likely that the process of starting metastases has already begun, and it is already extremely difficult to change anything.

Scientists are paying more and more attention to such a branch of medicine as oncology. This interest is caused by the fact that every year the number of cancer patients is growing rapidly. Many people believe that this area of ​​medicine only affects malignant tumors, but this opinion is wrong. Oncology involves the study of benign and malignant neoplasms, as well as the etiology of their appearance and development, methods of prevention, treatment and diagnosis. In parallel with the increase in incidence, the question arises among people about what a blood test for tumor markers shows, and how to decipher the results.

Tumor markers are specific protein compounds (antigens) produced by the cells of the tumor formation or cells located in close proximity to it. The body may also begin to produce proteins as a response to the development of a tumor. Tumor markers differ significantly from healthy human cells. Thanks to this, they can be identified using analysis at early stages of development. A small amount of cancer cells can also be detected in blood healthy people, but their significant increase is a cause for concern.

Oncological diseases are a broad group of pathological disorders. Neoplasms can affect any organs and systems of a person at any age, both women and men. There are a huge number of forms and variants of the course of oncological pathologies. When symptoms characteristic of the development of oncology appear, the doctor directs the patient to take a blood test for specific antigens corresponding to the location. Among the main and additional antigens, depending on the location of the tumor, the following are distinguished:

• head and neck area - SCCA;
• stomach - REA, CA 19-9, CA 50, CA 72–4, CA 125 is additionally determined;
• biliary system - antigens CEA, CA 19-9, CA 50;
• lungs - CYFRA 21-1, CEA, NSE, SCCA, additionally examine CA 72-4, MUC1, AFP, CA 15-3, 2MG, TPS, ferritin;
• uterus - CEA, TPS, CA 15-3, CA 50, SCCA, in addition, antigens CA 19-9, MUC1, hCG, CA 125 are studied;
• mammary glands - main indicators CEA, TPA, CA 15-3, CA 50, CA 549, MPA, additional AFP, hCG, ferritin, CA 125, CA 19-9;
• bladder - CYFRA 21-1, CEA, TPS and 2MG;
• liver – main antigens AFP, CEA, CA 19-9, CA 50, ferritin, CA 125;
• esophagus – SCCA;
• pancreas – tumor markers CEA, CA 19–9, CA 50, additional indicators CA-125, NSE, ferritin, hCG;
• prostate - PSA, PKF, CA 50, ferritin, CA 15-3, MUC1 are additionally examined;
• rectum - REA;
• colon – CEA, CA 19–9, CA 50, ferritin, and also as an additional indicator of AFP;
• placenta - hCG;
• follicular thyroid carcinoma - TG, TG antibodies, MUC1, CEA, TRA, additionally test for NSE and ferritin;
• medullary thyroid cancer – calcitonin;
• central nervous system– the main tumor marker of NSE, additional ferritin;
• testicles – AFP and hCG, additionally ferritin;
• ovaries - antigens CA 72-4, CA 125, CASA, AFP, hCG, CA 19-9, CA 15-3, CEA are additionally examined;
• hematopoietic and lymphoid system - ferritin, NSE, 2MG, sialic acids.

Some indicators are significant when determining oncological pathologies of several organs and systems at once. When using tumor markers, the following tasks are solved: early diagnosis of a tumor, detection of metastases and assessment of the quality of treatment.

Norm and explanation of main indicators

Decoding the results of a blood test involves not only comparing them with the norm, but also comparing them with other indicators and examinations. Thus, the hCG hormone, as a tumor marker, can simultaneously be elevated in women with pathologies of the placenta and in men with testicular oncology. In this case, for setting accurate diagnosis required additional examination. Let us consider in more detail the main indicators under study, their norms and reasons for deviation.

CA-125 is a tumor marker for ovarian cancer. Normally it ranges from 4.0 to 8.8*/l (from 0 to 30 IU/ml). If the value exceeds 35 units/ml, then in 90 cases out of 100, ovarian cancer is confirmed. An increase in concentration of more than 30 units. possibly with malignant endometrial tumors or fallopian tubes in women, respiratory system and digestive tract. In small quantities, CA 125 is detected in: endometriosis, ademomyosis, cysts and inflammation of the ovaries, liver diseases, peritonitis.

CEA is a carcinoembryonic antigen produced by the walls of the fetal digestive tract during intrauterine development. As we grow older, production gradually stops. When interpreting the results, a result of no higher than 5 ng/ml is taken as the norm. When the level increases to more than 20 ng/ml, cancer of the mammary glands, uterus, ovaries, prostate, lungs, and digestive tract is possible. An increase of up to 10 ng/ml is possible in smokers, liver cirrhosis, intestinal polyps, and tuberculosis.

PSA is a specific protein produced by the prostate. A PSA blood test should be taken by all men over 40 years of age. Normal blood levels depending on age category varies from 0 to 4.5 ng/ml, an acceptable value is 6.5 ng/ml for men over 70 years of age. If the PSA value is suspicious pathological disorder, then it is necessary to carry out an analysis on free PSA(sPSA). Then their percentages are analyzed. PSA increases not only with oncology, but also with prostate adenoma or after a massage.

AFP or alpha-fetoprotein is a protein produced by the cells and tissues of the fetal digestive tract during intrauterine development. Normally it is up to 10 ng/ml or 8 IU/ml. An increase in concentration is possible in the following pathologies: liver carcinoma, metastasis in liver tissue, oncology of the digestive tract or respiratory tract, neoplasms in the ovaries in women and testicles in men. AFP also increases with cirrhosis, hepatitis, in pregnant women with the development of complications of the embryo, and with renal failure.

Explanation of additional indicators

In conditions modern laboratories possible definition huge amount tumor markers. The most common of them were discussed above. It is also necessary to briefly note equally important indicators that are determined when diagnosing tumor processes. For example, CA 15-3 is an antigen produced by the mammary glands in women. Normative value from 8.2 to 38 units/l. The tumor marker is important in assessing the effectiveness of treatment, as well as in diagnosing oncology of the digestive tract and organs of the female reproductive system (uterus, ovaries).

Determination of the CA 19-9 antigen is necessary when diagnosing tumors of the digestive tract in the initial stages, as well as for neoplasms of the mammary glands, ovaries, uterus, gall bladder and bile ducts. When decoding, a result from 0 to 37 units/ml is taken as the norm; a content level of more than 40 IU/ml is considered extremely high.

Tumor marker CA 72-4 is normally no more than 6.9 units/ml and is highly informative in diagnosing gastric cancer. The indicator is also important when examining patients with tumors in the lungs and ovaries.

The CYFRA 21-1 antigen is the most significant tumor marker for diagnosing malignant bladder tumors and non-small cell lung cancer. Normal concentration levels are up to 3.3 ng/l. As a rule, the analysis is carried out simultaneously with REA and their significance is considered together. Ferritin is a nonspecific tumor marker used in the diagnosis of malignant diseases of the blood, ovaries, intestines, prostate, lungs, testicles, thyroid, breast and pancreas.

An important indicator in diagnosing diseases of the reproductive system is hCG ( human chorionic gonadotropin person). Normally, it does not exceed 2.5 mIU/ml in men and 5.3 mIU/ml in women. As the main indicator, hCG is considered in the diagnosis of oncological processes in the ovaries and testicles in conjunction with AFP. At the same time, their simultaneous increase is typical. As an additional hCG test determined during examination of patients with suspected malignant tumors of the uterus, mammary glands, and pancreas.

Blood tests for tumor markers are highly informative if you follow the recommendations before donation. The preparation is simple and consists of eliminating alcohol, medicines, physical and emotional stress, as well as refusing food for 8-10 hours. It is important to remember that deviation of results from the norm is not always an indicator of oncology. Their change can be provoked by natural physiological processes(change of menopause in women, pregnancy, menstruation), inflammatory reactions or infection of the body. The decoding should be done by a doctor, since not only tumor markers are important, but also other examination results.

Tumor markers are specific proteins or derivatives that are produced by cancer cells during their growth and development in the body. The tumor process promotes the production of a special kind of substances, which, by the nature of the functions they perform, are radically different from the substances produced normal body. In addition, they can be produced in quantities that significantly exceed the norm. During the analysis of oncological process These substances are detected. If oncology develops in the body, the number of tumor markers increases significantly; in connection with this circumstance, these substances prove oncological nature diseases. Depending on the nature of the tumor, tumor markers also differ.

Discovery History

The date of birth of tumor markers is considered to be 1845, it was then that a specific protein was discovered, which was named Ben Jones. It was first discovered during a urine test, and the doctor Ben-Jones himself at that time was a young and promising specialist and worked in London at St. George's Hospital. It was during this period that biochemistry, and with it immunology, developed at tremendous speed, which made it possible to subsequently identify an even larger number of proteins, which subsequently became tumor markers. In practical healthcare, no more than two dozen tumor markers are used.

In Russia, it served as a model for the detection of tumor markers. When studying protein composition cancer cells, scientists thought they would discover protein antigens of the virus that allegedly caused the disease. How surprised they were when they learned that the liver cancer marker is nothing more than AFP alpha-fetoprotein, which is normally produced by placental tissue during pregnancy. Over the years, it became clear that the amount of this protein is also increased at. It was this marker that first began to be used for diagnosis and was widely introduced into medical practice.

So what are tumor markers for?

Tumor markers are represented by enzymes, proteins, hormones or antigens that are secreted only by specific cancer cells and are not similar to each other. Some tumors may produce several tumor markers, while others may produce only one. So, a marker such as CA19-9 indicates that the oncological process has affected the pancreas and stomach. And tests for tumor markers allow you to carefully monitor the tumor, assess the dynamics of both conservative and surgical treatment, their results and future prospects.

Tumor markers are determined in blood or urine. They get there as a result of the growth and development of the cancer cell, and sometimes due to some physiological conditions(for example, during pregnancy). There are two types of markers, the first has high specificity and characterizes each specific case, and the second can occur with a number of tumors. Identification of tumor markers can identify a high-risk group for cancer. It is also possible to identify the primary focus even before the start of initial examination. It is also possible to predict a possible relapse of the disease or assess how effectively the operation was performed.

Most frequently identified tumor markers

It is also determined, which increases with the development of myeloma and some (tumors of the hematopoietic system). Its quantity predicts the outcome of the disease; at a level above 3 ng/ml, it is not entirely favorable. Marker CA 15-3, CA 27.29 indicates development. As the disease progresses, its amount increases; it is also determined in some other diseases.

The standard marker for ovarian cancer is CA 125, which rises above 30 ng/ml. But it can also be present healthy women, as well as in the presence of endometriosis, with effusion into the pleural or abdominal cavity, with lung cancer or with previous cancer.

Carcinoembryonic antigen (CEA) indicates the development, but also characterizes either the mammary glands, liver, or. And what’s most surprising is that it can also occur in healthy smokers. This marker is not specific, but tissue polypeptide antigen is characteristic only of lung cancer.

Method of determination

A tumor, be it malignant or benign, produces special proteins in the body. They can only be detected by examining body fluids, but AFP alpha-fetoprotein allows one to suspect cancer of the liver, testicles or ovaries (embryonic cancers), as well as lung or breast cancer. But it can also be increased in case of liver pathology (cirrhosis, hepatitis) or kidneys, and during pregnancy, its increased amount can cause fetal defects. For research, fluid is taken from the pleura, amniotic sac, abdominal cavity(ascitic fluid) or blood.

Prostate-specific antigen requires blood or serum, and often prostate juice or urine is taken for testing. It can also be used to search for tumor markers or urethra, and also, blood will be needed for the study.

Often, it is blood and urine, due to their greatest availability, that make it possible to isolate tumor markers, which are determined through complex biochemical studies and reactions that are performed in the laboratory. You can always find out the norm or deviation from it from your doctor.

The most common types of cancer and tumor markers

In 2/3 of patients, AFP alpha-fetoprotein often increases, which is a tumor marker of liver cancer and increases as the tumor process grows. In addition, this liver tumor marker increases during acute and chronic hepatitis, and sometimes ovarian cancer or, but this category of patients accounts for no more than 5%.

During development or lymphomas, beta - 2 - microglobulin is determined and it is this tumor marker that is prognostic for survival.

The presence of CA 15 3 and CA 27.29 indicates breast cancer, but initial stage diseases they exceed the norm slightly. As it progresses, the rate increases.

CA 125 indicates ovarian cancer and is elevated in most patients; it is this tumor marker of ovarian cancer that allows a preliminary diagnosis to be made at the stage of medical examination. But it can also be increased with other gynecological diseases or, as well as in cancer survivors. Also detected as a marker of ovarian cancer and LASA-P, but they can also be present in gastrointestinal oncology.

CA 19 9 is characteristic of damage to the pancreas, as well as with the effectiveness of treatment. This marker can increase with, or bile ducts.

The level of blood sampling to identify tumor markers should be:

Taking blood for tumor markers

• during the first year after treatment, 1 time per month;
• during the second year after treatment, once every two months;
• during the third year after treatment 1 time;
• over the next 3–5 years - twice a year, and then annually.

In this regard, it should be noted that deviations in the levels of one or more tumor markers in tumor diseases occur in 80-90% of patients with oncological diseases, but this does not always indicate that increased concentrations of cancer markers lead to tumor enlargement.

Norm and interpretation of tumor markers

PSA – prostate-specific antigen, prostate tumor marker

In the blood of men, determination of the level of antigen must be carried out after reaching 40 years of age, especially for those who have had even slight hyperplasia of the prostate gland (prostate). An increased level of antigen to high numbers clearly indicates. However, it can also be increased in cases of benign prostatic hypertrophy), prostatitis, and trauma to the prostate gland.

PSA norm – in blood –<4 нг / мл

Calcitonin is a hormone produced by the thyroid gland, and thyroglobulin is a protein produced by the thyroid gland. These two connections are markers. Having monitored the level of people who have benign thyroid nodules, we can say that no increase was detected in them.

AFP alpha-fetoprotein

– a tumor marker, which is a glycoprotein of fetal cells. Its level is mainly increased in pregnant women and newborns. In other cases, the interpretation of increased AFP most likely implies a primary cancer (not as a result of metastasis of another type of cancer) of the liver. This type may be increased in such cases if there are liver diseases, i.e. hepatitis, liver cirrhosis, liver toxicity and inflammatory bowel disease.

The norm is 0-10 IU/ml. An increase in AFP above 400 E indicates cancer.

AFP and hCG (human chorionic gonadotropin)

Characteristic of embryonal or ovarian cancers is an increased level of AFP and. It may also be elevated during pregnancy, marijuana use, liver cirrhosis, testicular failure, and inflammatory bowel disease.

Norm<2,5 Ед / мл

CA 15-3 – breast tumor marker

– this type of marker usually increases in breast cancer (without increasing in the early stages), as well as in lung cancer, ovarian cancer, endometrial cancer, and bladder cancer. It can be increased in liver diseases (cirrhosis, hepatitis), lupus, tuberculosis, and non-cancerous diseases of the breast.

Norm<31 Ед / мл

– this tumor marker is mainly elevated in cancer of the pancreas, liver, stomach, gallbladder, and bile ducts. In such cases, where there is pancreatitis, inflammatory bowel disease, inflammation or obstruction of the biliary tract, it may increase.

Normal in blood<37 Ед / мл

CA 125

– this type of marker is common in diseases such as cancer of the ovaries, breast, colon and rectum, uterus, cervix, pancreas, liver and lungs. It has properties to increase during pregnancy and menopause, the presence of endometriosis, ovarian cysts, fibroids, pancreatitis, liver cirrhosis, peritonitis, pleurisy, after surgery or puncture of the abdominal cavity.

Normal 0-35 U/ml

It should be noted that there are two types of reasons for conducting analysis for the CA 125 tumor marker:

• diagnosis of ovarian pathology, screening of neoplasms;
• Diagnosed pancreatic adenocarcinoma.

If the CA 125 tumor marker is present, the decoding indicates oncopathology or somatic pathology.

With an increased level of this tumor marker, the decoding identifies the following oncological pathological processes as:

• cancer of the ovaries (up to 80% of cases), fallopian tubes, uterus, endometrium;
• liver cancer;
• lung cancer;
• cancer of the stomach, rectum, pancreas;
• malignant breast formations.

An increased concentration of the tumor marker CA 125 may indicate a somatic pathology:

• endometriosis;
• inflammatory processes in the uterus and appendages;
• cystic formations of the ovaries;
• pleurisy, peritonitis;
• liver cirrhosis, chronic forms of hepatitis;
• chronic pancreatitis;
• autoimmune pathology.

CEA (carcinoembryonic antigen) or PEA

() is a marker for cancer of the breast, lungs, stomach, pancreas, bladder, kidneys, as well as some tumors of the thyroid gland, cervix, ovaries, and liver. An increase in tumor marker is affected by smoking, pancreatitis, hepatitis, intestinal inflammation, gastrointestinal ulcers, hypothyroidism, liver cirrhosis, chronic obstructive pulmonary disease and obstructive process of the biliary tract.

Standard for non-smokers<2,5 нг / мл, для курильщиков <5 нг / мл

An increase in level above 100 ng/ml indicates metastatic cancer.

Tests for tumor markers

To ensure that the test does not give a false positive result or is not negative in the presence of cancer, you should adhere to certain rules before taking it.

You can find out more detailed information from your doctor, because each specific tumor marker requires its own preparation. So, before taking the test, you should not eat food, and donate blood on an “empty stomach.” A person’s last consumption of food should be no earlier than 8, and better than 12, hours before blood sampling. The food also contains protein, which, when entering the bloodstream, can lead to a false positive result.

The analysis for tumor markers, like all others, is best done in the morning; the optimal time is before 11 o’clock. An important aspect is also considered that three days before the test you should not drink alcoholic beverages. Also, during the same period of time, it is necessary to refrain from consuming fatty foods and not subject your body to excessive physical activity. And on the day of delivery it is best not to smoke. It is also not advisable to consume medications, and if it is impossible to refuse them, then you should inform your doctor about this. A week before taking the test for tumor markers, you must abstain from sexual intercourse.

Monitoring tumor markers in cancer treatment

Tumor markers play a very important role in cancer therapy. Specialists who monitor changes in the levels of specific tumor markers can also monitor the results of patient treatment.

Here's an example: During chemotherapy or radiation therapy for various forms of cancer, there is a rapid increase in the level of tumor markers. And this does not mean that the cancer is getting worse. On the contrary, it signals tumor lysis. When the tumor decomposes, there is a sudden explosion of these substances in the blood test. And after treatment, the doctor continues to monitor the level of markers, which, together with other tests, help assess the patient’s health status.

What question should you ask your doctor after conducting a blood (urine) test for tumor markers?

Naturally, after a person visits a doctor, natural questions should arise that are worth asking. If there are no questions, then you can ask the most common ones and get an answer that will satisfy your initial interest.

• The first thing any patient should be interested in is whether the tumor markers are elevated?
• If there is an increase, then for which tumor marker and what could this mean for further diagnosis, as well as prognosis for the development of the disease?
• If you have oncology and have been tested for markers, is it necessary to adjust the prescribed treatment or what is available is quite effective?
• It is also necessary to have information about how often to get tested for tumor markers.

There is no need to be shy about asking questions; in some cases, they will help save lives, as well as early diagnose such a formidable disease as cancer, which is on the list of leaders in the number of deaths in human lives.

Informative video: What is a tumor marker and how to treat oncological diseases?