1. alpha-fetoprotein
Normal reference value: 0 ~ 25 ng/ml
AFP is an index for early diagnosis of primary liver cancer, and the significant increase of AFP content generally indicates primary hepatocellular carcinoma, which is suitable for large-scale screening. 70%~95% of patients with liver cancer have increased AFP, and the more advanced it is, the higher the AFP content is. But negative does not rule out primary liver cancer.
AFP level reflects the size of tumor to a certain extent, and its dynamic changes have a certain relationship with the condition, which is a sensitive index to show the therapeutic effect and prognosis judgment. An abnormally high AFP value usually indicates a poor prognosis, while an increase in AFP content indicates a worsening condition.
Two months after liver cancer surgery, AFP
The value should be reduced to below 20 ng/ml. If the decline is not much or it rises again, it means that the resection is not complete or there is the possibility of recurrence and metastasis in the near future. For metastatic liver cancer, AFP value is generally lower than 350-400.
The moderate increase of ng/ml AFP is also common in alcoholic cirrhosis, acute hepatitis and HBsAg carriers. Some digestive tract cancers can also have an increase in AFP (gastric hepatoid adenocarcinoma).
2. Carcinoembryonic antigen
Normal reference value: 0 ~ 5 ng/ml
Cost Effectiveness Analysis (cost effectiveness analysis)
It is an important tumor-associated antigen, and 70%-90% of colon adenocarcinoma patients have CEA.
It is highly positive. Among other malignant tumors, the positive rate is gastric cancer, pancreatic cancer, small intestinal adenocarcinoma, lung cancer, liver cancer, breast cancer and urinary system tumor. Carcinoembryonic antigen in gastric juice, saliva and hydrothorax and ascites
The positive detection rate of CEA is high, because CEA in these tumor "soaking solution" can exist before blood. CEA content is related to tumor size and metastasis. Cost Effectiveness Analysis (cost effectiveness analysis)
Determination is mainly used to guide the treatment and follow-up of various tumors.
3. Cancer antigen 125(CA 125)
Normal reference value: 0 ~ 35 u/ml
CA 125 is the first choice for ovarian cancer and endometrial cancer. The most important indicators are early diagnosis, curative effect observation, prognosis judgment and monitoring recurrence and metastasis of ovarian cancer. The diagnostic coincidence rate of tubal cancer, endometrial cancer, cervical cancer, breast cancer and mesothelial cancer is also very high, and the positive rate of benign lesions is only 2%.
The increase of CA 125 can also be seen in ascites caused by various malignant tumors. The slight increase of CA 125 can also be seen in many gynecological benign diseases, such as ovarian cyst, endometriosis, cervicitis and hysteromyoma, gastrointestinal cancer, cirrhosis, hepatitis and so on.
4. Cancer antigen 153(CA 15-3)
Normal reference value: 0 ~ 25 u/ml
CA 153
It is the most important specific marker of breast cancer. 30%-50% of breast cancer patients have CA 15-3.
It is obviously increased, and the change of its content is closely related to the curative effect, which is the best index for diagnosing and monitoring the postoperative recurrence of breast cancer patients and observing the curative effect. Serum CA 15-3 in patients with lung cancer, gastrointestinal cancer, ovarian cancer and cervical cancer.
It can also be elevated, and it is necessary to identify it, especially to exclude the increase in content caused by partial pregnancy.
5. Cancer antigen 199(CA 19-9)
Normal reference value: 0 ~ 37 u/ml
CA 199
It is a related marker of pancreatic cancer, gastric cancer, colorectal cancer and gallbladder cancer. 85%-95% of patients with pancreatic cancer are positive. The positive rate of gastric cancer, colorectal cancer, gallbladder cancer, cholangiocarcinoma and liver cancer will also be high. Many benign and inflammatory diseases of gastrointestinal tract and liver, such as pancreatitis, mild cholestasis and jaundice, CA 199.
The concentration can also be increased, but it is often transient, and its concentration is mostly lower than 100U/ml.
6. Cancer antigen 724(CA72-4)
Normal reference value: 0 ~ 6 u/ml
CA724 is one of the best tumor markers in the diagnosis of gastric cancer, with high specificity and sensitivity of 28-80%. If combined with CA 199 and CEA, more than 66% of gastric cancer can be monitored. CA724 can also be detected in other digestive tract tumors, breast cancer, lung cancer and ovarian cancer.
7. Cancer antigen 242
Normal reference value: 0 ~ 20 u/ml
CA242
It has high sensitivity and specificity for pancreatic cancer and colorectal cancer, with positive detection rates of 86% and 62% respectively, and also has certain positive detection rates for lung cancer and breast cancer. It can be used for differential diagnosis and prognosis of pancreatic cancer and benign hepatobiliary diseases, and can also be used for preoperative prognosis and recurrence differentiation of patients with colorectal cancer. Cost Effectiveness Analysis (cost effectiveness analysis)
Compared with the combined detection of CA242 and CEA alone, it can be increased by 40-70% for colon cancer and 47-62% for rectal cancer.
8. Cytokeratin 211(cyfra21-1)
Normal reference value: 0 ~ 4 ng/ml
CYFRA 2 1- 1 is the most valuable serum tumor marker for non-small cell lung cancer, especially suitable for early diagnosis, curative effect observation and prognosis monitoring of patients with squamous cell carcinoma. CYFRA 2 1- 1 can also be used to monitor the course of invasive bladder cancer, especially to predict the recurrence of bladder cancer.
9. Neuron specific enolase
Normal reference value: 0 ~ 15 ng/ml
NSE is considered as the first choice for monitoring small cell lung cancer, and it is increased in 60-80% of patients with small cell lung cancer. NSE is an effective marker for monitoring the curative effect and course of small cell lung cancer, and can provide valuable prognostic information. In addition, NSE can also be used as a marker of neuroblastoma, which has certain reference value for early diagnosis, curative effect evaluation and recurrence prediction of the disease.
10. Squamous cell carcinoma antigen
Normal reference value:
SCC is a specific tumor marker and the earliest diagnosis of squamous cell carcinoma. It can be used for diagnosis and disease monitoring of cervical cancer, lung cancer (non-small cell lung cancer), head and neck cancer, esophageal cancer, nasopharyngeal cancer, vulvar squamous cell cancer, bladder cancer, anal canal cancer, skin cancer and other tumors.
Total prostate specific antigen (TPSA).
Normal reference value: 0 ~ 4.0 ng/ml
PSA is a specific marker of prostate cancer and the only recognized organ-specific tumor marker. Elevated serum TPSA generally indicates the existence of prostate diseases (prostatitis, benign hyperplasia or cancer).
12. Free prostate specific antigen (FPSA)
Normal reference value: 0 ~ 2.0 ng/ml FPSA/TPSA: > 0.15.
The determination of serum TPSA alone can not clearly distinguish prostate cancer from benign prostatic hyperplasia. FPSA/TPSA for prostate cancer patients
The ratio is obviously lower, while the FPSA/TPSA ratio of patients with benign prostatic hyperplasia is obviously higher. FPSA/TPSA
The critical value is 0. 15, below which prostate cancer is highly suspected. Its diagnostic sensitivity is 90.9%, specificity is 87.5%, and accuracy is 88.6%, which is obviously better than TPSA alone.
13. Serum ferritin
Normal reference value: male: 30 ~ 400 μ g/L female: 13 ~ 150 μ g/L.
The increase of SF can be seen in the following tumors: acute leukemia, Hodgkin's disease, lung cancer, colon cancer, liver cancer and prostate cancer. The detection of ferritin has diagnostic value for liver metastases. The ferritin content of 76% patients with liver metastases is higher than 400μ g/L. When the AFP value in liver cancer is low, the ferritin value can be supplemented to improve the diagnostic rate.
14. gastrin precursor release peptide
Normal reference value: 2 ~ 50 pg/ml
PROGRP is a new marker of small cell lung cancer. As a marker of small cell lung cancer, it has the following characteristics: 1. Its specificity for small cell lung cancer is very high; 2. The positive rate of early cases is high; 3. The blood concentration of healthy people and patients is very different, so the detection reliability is very high.
Timetable for combined application of tumor markers: