Tumor markers alone cannot provide a definitive diagnosis

□ Zhang Zhiyang and Wang Yingyi

As an important part of the physical examination package, the detection of serum tumor markers is a non-invasive and most well-known cancer screening method. What is the significance of common tumor marker tests? What should I do if the indicators are abnormal?

Abnormal tumor markers do not necessarily mean you have a tumor

Tumor markers refer to substances that are characteristically present in malignant tumor cells or are produced by the metabolism of tumor cells, and also include substances produced by the host's response to tumor stimulation. Since tumor markers are cellular metabolic products, in addition to tumor cells, cells in the body may also secrete or produce certain metabolites when the body is in an inflammatory or benign disease state. Therefore, an increase in tumor markers does not necessarily mean that a tumor is present, and even tumor markers in patients with malignant tumors may be completely normal.

Surgery or biopsy pathology is the gold standard for tumor diagnosis

If a physical examination finds that the tumor markers are elevated, the physical examination institution will generally give a reminder and recommend that you go to the hospital's oncology department for treatment. For healthy people, tumor markers should generally be within the normal range. Even if there is a slight increase occasionally, the increase will not be large. At this time, further judgment is required through reexamination and monitoring. If the tumor markers are getting higher and higher, further examination should be performed.

For cancer patients, the increase in tumor markers can help monitor tumor recurrence and evaluate the efficacy of treatment.

It should be noted that tumor markers alone cannot confirm a tumor. A definitive diagnosis requires surgical pathology or biopsy pathology. Elevated tumor markers need to be taken seriously but there is no need to panic. Listen to the advice of oncologists, conduct follow-up observations or further diagnosis, identify the cause, and solve the problem.

Standardized screening of tumors is the most important

More important than elevated tumor markers is standardized tumor screening. Early screening of tumors is crucial, especially for people over 40 years old.

For example, for gastrointestinal cancer, it is recommended to start the first gastroscopy at the age of 40 to screen for gastrointestinal polyps or ulcers; for lung cancer, high-resolution chest CT screening every 2 to 3 years is also important; female breast cancer and gynecological tumors related to gender need to be screened through annual breast and gynecological color ultrasounds; male prostate cancer can be screened through prostate color ultrasound. Perfecting this series of early cancer screening can achieve early screening, early diagnosis and early treatment of cancer to the greatest extent.

(The author Zhang Zhiyang is the attending physician of the Department of Oncology at Peking Union Medical College Hospital, and Wang Yingyi is the chief physician of the Department of Oncology at Peking Union Medical College Hospital)