Tumor Markers - Norm And Interpretation Of AFP Tumor Marker Results, Table

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Tumor Markers - Norm And Interpretation Of AFP Tumor Marker Results, Table
Tumor Markers - Norm And Interpretation Of AFP Tumor Marker Results, Table

Video: Tumor Markers - Norm And Interpretation Of AFP Tumor Marker Results, Table

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Video: Tumor Markers: AFP, CA 125, CEA, hCG, PSA - clin chem review 2023, January
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Last updated 10 July 2017 at 08:24 PM

Reading time: 7 minutes

There are a number of cancer-specific proteins, antigens, and substances (for example, the AFP tumor marker) that can be associated with malignant tumors. In this case, there may be such a situation when tumor markers are in the range of normal values, but the disease will be detected as a result.

In other words, in the early stages of cancer, only some of the cancer-specific indicators may have increased values, and a number of other reasons often lead to their increase.

Content

  • 1 What You Should Look For When Taking Cancer Tests
  • 2 The concept of a tumor marker and its features
  • 3 Tumor markers as relative indicators of cancer risk
  • 4 Where to pass oncomarkers and find out the data on the norm?
  • 5 Normative and increased values ​​of tumor markers
  • 6 Prostate-specific antigen: risk assessment of the prostate
  • 7 Alpha-fetoprotein: liver tumor marker
  • 8 Cancer-embryonic antigen
  • 9 Conclusion

    9.1 Related articles

What to look for when taking cancer tests

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Tumor markers for diagnosis are used only in conjunction with other clinical data and mostly for preliminary screening of the disease or monitoring treatment.

An increase in the indicator can be caused by a certain physiological state. That, for example, is typical for specific proteins of malignant lesions of the ovaries and mammary glands, which increase during critical days.

The concept of a tumor marker and its features

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The indicators of most tumor markers are used in modern medicine to diagnose cancer.

In most cases, they represent a specific protein structure, substance or antigen, their increased content in the patient's sample may indicate the presence of a malignant process. However, this is not always the case.

For example, the marker of cancer embryonic protein (CEA), which is often used in examinations, can also increase with benign cell changes.

Oncormarker ca-125, which is used to assess ovarian tumors, rises during critical days and in some reproductive pathologies. Bone phosphatase is often used as a tumor marker for metastases, while this analysis is done only by a limited number of laboratories, and an increase in alkaline phosphatase can be caused both with damage to the gastrointestinal tract, and, for example, by pregnancy.

As a rule, highly elevated tumor markers in human blood are characteristic of advanced stages of cancer. In the first and second stages, normative data are often observed.

Tumor markers as relative indicators of cancer risk

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In other words, tumor markers are relative indicators of an assessment of the likelihood of cancer.

Please note that accurate diagnosis of the disease is very important in order to properly plan the surgical intervention. Both increased and normal results when donating blood for tumor markers will not give an accurate answer about the presence of oncology. Moreover, specific proteins are often used to track the dynamics of anticancer treatment.

Where to pass oncomarkers and find out data on the norm?

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The rates of many tumor markers depend on the method and test system used in the laboratory of your choice. Information on the range of values ​​of tumor markers will be contained in the analysis results that will be given to the patient in the laboratory. Typically, value ranges are listed in the adjacent column next to the patient's result.

If you use the value of the selected tumor markers as estimates of your own health status, for accuracy it is better to take tests using the same methods and test systems.

The reference data of tumor markers can be obtained in the laboratory directly or on the official website.

Standard and increased values ​​of tumor markers

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In our review, the normative results of some tumor markers are given, as well as the test systems that are usually used to conduct the assessment. We would like to draw your attention once again to the fact that both normative and increased indicators do not allow making accurate conclusions about the presence or absence of cancer.

HE4 epithelial ovarian cancer tumor marker (ARCHITECT test system)

Standard values:

  1. premenopause: less than 70 pmol / l, less than 7.4%;
  2. postmenopause: less than 140 pmol / l, less than 7.4%.

A tumor marker is used to clarify the nature of neoplasms in the uterine appendages before surgery.

HE4 is only used to assess the likelihood, not to make a precise diagnosis. Moreover, a normal level of HE4 can also be characteristic of women with epithelial cancer, this is due to the fact that some types of ovarian cancer rarely secrete this protein, but it occurs in germ cell and mucoid tumors.

There is also evidence of an increase in this protein in non-sick women, as well as in patients with other types of tumors (gastrointestinal tract, breast, endometrium, etc.).

Guideline values: <6.9 U / ml.

This indicator is used to further assess the likelihood of malignant damage to the reproductive organs, gastrointestinal tract and lungs. Increased values ​​can be typical for oncological diseases of the liver, large intestine, stomach and pancreas, benign and malignant neoplasms.

An increase in the values ​​of this carbohydrate antigen can be observed in patients with rheumatism and cirrhosis, as well as in those suffering from pancreatitis.

Decoding of most tumor markers can be done based on a combination of test results, MRI and CT. Oncomarker CA 72-4 is used for predictive testing of the likelihood of malignant organ damage.

Carbohydrate antigen CA 15-3: assessment of the likelihood of breast cancer

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Guideline values: <26.9 U / ml (healthy women outside of pregnancy).

Oncomarker CA 15-3 changes dramatically in various oncopathologies of the female breast. A high level is characteristic of the last stages of a malignant disease with metastases. This carbohydrate antigen increases with carcinoma of the bronchi, breast, cancer of the reproductive organs and gastrointestinal tract.

Also, increased values ​​are characteristic of a benign breast process (up to 50 U / ml), the marker rises in the third trimester of pregnancy (up to 50 U / ml). This test is used in conjunction with the definition of CEA.

Carbohydrate antigen CA-125: risk assessment of ovarian cancer

Guideline values: <35 U / ml.

The CA-125 tumor marker grows in a number of somatic diseases and cancer of various organs. The accuracy of this indicator for the ovaries is 80%.

In the absence of ovarian damage and an increase in this antigen, it is worth checking the following organs for neoplasms: the reproductive organs of a woman, the digestive tract, and the lungs. In somatic diseases, there is often a small increase in antigen: cysts of the reproductive organs, endometriosis, chronic liver damage, autoimmune disorders, etc.

Carbohydrate antigen CA 242: risk assessment of gastrointestinal cancer (Fujirebio test system, ECLIA method)

Guideline values: <29.0 U / ml.

The carbohydrate antigen CA 242 is used to assess the likelihood of cancer and gastrointestinal damage. It is observed in colorectal oncology, pancreatic tumor, stomach cancer. In 5-33% of cases, it can grow with a benign neoplasm of the digestive tract.

Carbohydrate antigen CA 19-9: squamous cell carcinoma test

Guideline values: <37 U / ml.

An increase in the level of this tumor marker in 70-100% of cases is observed in oncopathology of the pancreas. Also, increased values ​​can mean the presence of oncology of the liver and gallbladder, up to 51% of cases. In some cases, there is a growth of a tumor marker in cancer of other organs of the gastrointestinal tract, oncopathology and damage to the female reproductive organs. Also, the carbohydrate antigen CA 19-9 increases with stones in the gallbladder, severe liver damage and other diseases.

Prostate-specific antigen: prostate risk assessment

Standard values ​​(for men):

  • up to 40 years old: up to 1.4;
  • 40-50 years old: up to 2.0;
  • 50-60 years old: up to 3.1;
  • 60-70 years old: up to 4.1;
  • over 70 years old: up to 4.4.

The antigen is used to assess the condition of the prostate, it rises in all types of lesions - inflammatory and benign, especially grows in a malignant oncological process.

Microglobulin in urine Beta 2

Standard values: from 0 to 300 ng.

Microglobulin in urine Beta 2 in clinical practice is evaluated only when it is increased. In some cases, it can be observed with tumor damage to the kidneys. Microglobulin Beta 2 tests are often done during treatment. Its increase is typical for some non-neoplastic kidney diseases and renal implant rejection.

Alpha-fetoprotein: liver tumor marker

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Guideline values: <5 ng / ml, for non-smokers, for smokers it can rise up to 10 ng / ml.

CEA tumor marker is used to test the likelihood of an oncological process. This antigen is produced only in the embryonic period, but it can increase in a number of diseases, as well as in benign and malignant processes. A significant increase in the marker is observed at stages 2-3 of cancer.

β-hCG total: chorionic gonadotropin for the determination of choriocarcinomas (Cobas 6000 test system, ECLIA method)

Standard values:

  1. women (non-pregnant): <1.0 IU / L;
  2. women (postmenopausal): <7.0 IU / L;
  3. men: <2.0 IU / L.

The marker belongs to the group of glycoprotein hormones, a significant increase in the level is observed in the pathology of pregnancy (belly skid) and choriocarcinomas, as well as in some tumors that can occur in the ovaries and testes. The analysis is informative for pregnant women for up to 4 weeks.

Neuron-specific enolase: for the detection of neuroendocrine tumors (Cobas 6000 test system, ECLIA method)

Guideline values: <16.3 ng / ml.

It is used for the diagnosis of neuroendocrine tumors, relapse and monitoring of the disease, the determination of metastases. It increases only in some tumors of neuroendocrine origin. The indicator also increases with a number of diseases of the nervous system.

Cytokeratins Cyfra 21-1: for detection of tumors of the lung, uterus and bladder (Cobas 6000 test system, ECLIA method)

Guideline values: <3.3 ng / ml.

The marker is a structural protein that is used for the non-invasive diagnosis of lung neoplasms, as well as non-small cell cancer of the lung, uterus, and bladder. May rise in benign lesions of the liver, lungs, kidney failure, and smoking.

Tumor marker protein (protein) S-100: for the detection of malignant melanoma of the skin (Cobas 6000 test system, ECLIA method)

Guideline values: <0.105 μg / L.

Protein S-100 is used as a prognostic indicator for brain injuries and for the detection of malignant skin melanoma. It can increase with strong physical exertion, Alzheimer's disease, and various inflammatory diseases.

Conclusion

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To make a diagnosis, a number of relative and absolute indicators are used, as well as methods of qualitative assessment of neoplasms, for example, CT and MRI. For the initial assessment of the risk of disease, you can use both the usual general and extended blood tests.

A malignant process, as a rule, contributes to a significant increase in fibrinogen and ESR. An increase in alkaline phosphatase in the presence of a tumor process may indicate metastases, while this indicator is relative, since the substance plays a protective role for the gastrointestinal tract and increases in a number of somatic diseases.

For a comprehensive assessment of cancer risk, sets of tumor markers are used, presented in the form of oncological panels. Comprehensive assessment methods can be found on the website of the selected laboratory.

Keep in mind that the list of cancer-specific tests is much wider. Some laboratories offer to send analyzes to Japan or Germany. Russia also has several high-tech laboratories that can make an accurate assessment of the likelihood of disease.

The accuracy of the analysis is determined by the test system used, supplied by the largest medical manufacturers. To obtain an accurate result of monitoring a tumor marker, the coincidence of the assessment method is required.

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