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— Oncology — Checking blood for tumor markers
Oncological diseases take second place after cardiovascular pathologies among the causes of death of patients in Russia. Negative statistics are associated with late detection of pathology. According to experts, with the help of early diagnosis, the survival rate of cancer patients can be doubled. There are plenty of methods for this.
Among the most common methods of early diagnosis of cancer is a blood test for specific chemical compounds - tumor markers. Based on its results, it is impossible to accurately determine whether a person has cancer or not. The diagnostic value of the study is the ability to suspect the initial stage of the disease by continuing the study using clinical methods.
What tumor markers are used to diagnose stomach cancer?
CA-19-9
This marker is produced by epithelial cells of the gastrointestinal tract. Accordingly, in tumors originating from these cells, the level of CA19-9 increases significantly. The indicators change most with pancreatic cancer, but can also increase with cancer of the colon, liver, bile ducts and gallbladder, pancreatitis, and cystic fibrosis. Thus, given the low sensitivity and specificity, this indicator is not used for self-diagnosis and monitoring.
REA
CEA (carcinoembryonic antigen) is a protein, a tissue marker of oncopathology. It is used in the diagnosis of colon tumors, but can also be effective in stomach cancer. Normally, its levels are extremely low, but in the presence of a malignant neoplasm, its level increases sharply.
SA 72-4
CA 72-4 is a glycoprotein that is located on the surface of the epithelium of the gastrointestinal tract during human intrauterine development. In adults, it appears with colorectal cancer, stomach cancer and other malignant tumors. However, in 6.7% of patients, its increase was also detected in the presence of benign tumors.
Sensitivity for stomach cancer is 40-46%, and the higher the tumor marker, the more widespread the malignant process, i.e. there is a correlation with stage. After radical removal of cancer, the CA value of 72-4 returns to normal within 3-4 weeks. As for metastases, this tumor marker for stomach cancer is more sensitive than CEA or CA 19-9. The determination of CA 72-4 is carried out to assess the chances of survival in patients with an established diagnosis of gastric carcinoma. The higher the tumor marker, the higher the stage of the disease.
What do tumor markers show for stomach cancer?
In general, tests for tumor markers for stomach cancer are not highly sensitive or specific. This means that normal results do not guarantee the absence of a tumor, and elevated results do not mean the presence of cancer. However, when the tumor marker level increases tenfold, the likelihood of this increases.
The diagnostic value of the study of tumor markers increases with the simultaneous study of several indicators, for example, CA 19-9 and CEA, or CA 72-4 and CEA. But they still cannot be used for self-diagnosis of stomach cancer.
SA 19-9
Reference values for the CA19-9 tumor marker are in the range of 0-34 U/ml. Such indicators are observed in 95% of healthy people.
An increase in tumor marker levels may indicate the following diseases:
- Pancreas cancer. The higher the level of CA 19-9, the more widespread the pathological process. The highest concentration is observed in the presence of distant metastases, i.e. at the 4th stage of the disease.
- Stomach cancer.
- Colon cancer.
- Liver carcinoma.
- Cancer of the bile ducts and gallbladder.
- Ovarian cancer.
In addition, an increase in the level of this tumor marker is observed in some benign diseases:
- Hepatitis.
- Cirrhosis of the liver.
- Pancreatitis.
- Cholelithiasis.
- Cystic fibrosis.
REA
The REA reference values are as follows:
- For non-smokers below 3.8 ng/ml.
- For smokers - 0-5.5 ng/ml.
These are normal levels of CEA, characteristic of healthy people, but this result is also possible in the presence of a tumor that is insensitive to this test.
An increase in the level of this tumor marker can be observed in both malignant and benign diseases. Malignant tumors:
- Colon cancer.
- Stomach cancer.
- Lungs' cancer.
- Breast and pancreatic cancer.
Non-oncological diseases:
- Cirrhosis of the liver.
- Hepatitis.
- Intestinal polyps.
- Chronic inflammatory bowel diseases, such as ulcerative colitis.
- Some lung diseases, including tuberculosis.
- Autoimmune pathologies.
SA 72-4
Reference values for tumor marker CA 72-4 0-6.9 U/ml. A normal analysis indicator is typical for healthy people; an increase in its value is observed in the following cases:
- Stomach cancer.
- Some forms of ovarian cancer.
- Colorectal cancer.
- Lungs' cancer.
- Hepatitis.
- Cirrhosis of the liver.
- Ovarian cyst.
- Inflammation of the gastrointestinal tract.
Reliability and validity of tumor marker analysis results for gastric cancer
The reliability and validity of the results will depend on the following aspects:
- Features of collecting material and manipulating it before delivery to the laboratory.
- Diagnostic systems and equipment used for analysis.
- The presence of concomitant diseases that can lead to an increase in the concentration of the tumor markers being studied.
To obtain reliable results, it is recommended to take tests in accredited laboratories that have established pre-analytical and analytical stages of research, as well as internal and external quality control.
Advantages of contacting the City Medical Center
If you need to assess the state of your health and take timely measures to restore it, you can contact the City Medical Center. Our clinic is equipped with the latest equipment, which allows us to conduct laboratory tests in the shortest possible time and provide highly accurate diagnostic information. The specialists at our medical center are experienced, highly qualified doctors who are ready to help you regain your health and maintain your longevity. To schedule an examination, call or fill out the online form. If necessary, you can use and get tested without visiting the clinic. In addition, you have access to comprehensive diagnostic programs that include the entire range of laboratory and hardware examination methods.
Interpretation of tumor marker results in gastric cancer
A doctor who has experience in diagnosing and treating stomach cancer should prescribe and interpret the results of tumor marker tests. Interpretation is carried out on the basis of examination data, anamnesis and clinical picture. The isolated use of tumor markers for screening or detection of gastric cancer is unacceptable.
Normal values of stomach tumor markers do not guarantee the absence of malignant tumors. Such results can occur in early stages of cancer, when the level of the marker has not yet increased, or there are tumors that do not lead to an increase in its level at all.
Increased results also require additional examination, since they may indicate the presence of a tumor of another location or a non-oncological disease. In doubtful cases, testing for tumor markers of stomach cancer is prescribed over time. An increase in its level indicates the presence of a progressive disease, a decrease in the level of the marker indicates recovery.
Initially, very high levels of tumor markers, especially if their value is exceeded several times, with a high degree of probability indicates the presence of a malignant process, but does not guarantee this 100%, and even more so does not allow one to determine the type of neoplasm.
The most informative value for gastric cancer is the dynamic study of tumor markers. A decrease in their level indicates that the treatment was effectively carried out; normalization of indicators is noted after a radical operation.
If after treatment the tumor marker level begins to increase, this indicates either a relapse of the disease or its progression. If the indicators increase tenfold, this may indicate distant metastases.
When is analysis needed?
The need for this diagnostic study does not arise in all situations. According to the majority of experts, these types of protein can only confirm or refute the information available to the attending physician, as well as indirectly indicate the course of the cancer process.
Among the main indications for a blood test for esophageal cancer are, first of all, the presence of suspicious clinical signs, which may indirectly indicate the formation of an oncological process in this anatomical structure.
In addition, the study is prescribed to evaluate the effectiveness of radical surgery or the use of antitumor medications.
The analysis is also used when it is necessary to obtain prognostic data regarding the course of cancer, or for the purpose of annual screening of patients with precancerous conditions identified in them.
Causes of stomach cancer
How and why stomach cancer develops is not completely clear. But the influence of certain factors has been proven in which the likelihood of a tumor increases. These include:
- Chronic atrophic gastritis, especially against the background of hyperplastic processes of the epithelium. This disease was found in 60% of patients with stomach cancer. In this case, the localization of the process was important. For example, when atrophy is located in the antrum of the stomach, the risk of developing cancer increases 18 times, and with total damage to the organ - 90 times.
- Helicobacter Pylory infection. The likelihood of developing stomach cancer in such patients is 3-4 times higher than in the general population.
- Nutritional features. Containing a large amount of hot, spicy, pickled, salty foods, fast food, smoked meats and fats in the diet statistically significantly increases the likelihood of developing tumors of the gastrointestinal tract, including the stomach.
- Presence of adenomatous polyps. Such neoplasms have a relatively high risk of malignancy, so they are recommended to be removed in a timely manner.
- Smoking.
- History of gastric ulcer. When an ulcer is located in the body of the stomach, the risk of developing a malignant neoplasm increases by 2 times.
- History of gastric surgery. Increases the risk of developing cancer by 4 times.
- Menetrier's disease, which is characterized by hypertrophic gastropathy or hyperplastic giant-fold gastritis.
- Drunkenness and alcoholism.
- Pernicious anemia. Anemia with a malignant course, which develops due to the inability to absorb vitamin B 12. It is also accompanied by immunodeficiency conditions, which increases the risk of developing a malignant tumor by 10%.
- Hereditary predisposition. The presence of malignant stomach tumors in close blood relatives increases the risk of developing cancer in this location by 5-20%. It is believed that Napoleon Bonaparte and his father died from this disease.
- Immunodeficiency states.
- Working with carcinogenic substances.
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Symptoms
One of the biggest problems in diagnosis is that this disease does not have specific signs - manifestations that would clearly indicate this disease. Therefore, it is important to see a doctor as soon as possible if you experience any symptoms of possible stomach cancer:
- Pain of various types in the epigastric region (pulling, aching, dull), which may or may not be associated with food intake.
- Dyspeptic symptoms after eating (heartburn, bloating, feeling of a “stone” in the stomach, belching, early satiety).
- Problems with swallowing food (a feeling that the esophagus is pinched or that there is a foreign body in it).
- Unexplained weight loss, loss of appetite up to its complete absence.
- Congestive vomiting (vomit contains fragments of food that was eaten the day before) or vomit with traces of blood.
- Very dark or black stool.
