Blood test for stomach cancer: indicators for diagnosis

general description

Gastric cancer is a malignant tumor that develops from the cellular elements of the gastric mucosa.
It is widespread among the population and ranks second after lung cancer in terms of mortality from cancer. This is due to diagnostic difficulties: at an early stage, its symptoms are nonspecific and are often mistaken for signs of other diseases of the gastrointestinal tract. About 80% of patients do not complain at an early stage. It is known that dietary addictions contribute to the occurrence of stomach cancer: abuse of spicy foods, canned and fatty foods. Risk factors include frequent consumption of strong alcoholic beverages and smoking. Very often, this type of cancer develops against the background of existing chronic stomach diseases. Genetic determination of this pathology is possible.

Conventionally, stomach cancer is divided into three stages: I - the tumor diameter does not exceed 2 cm, penetrates only into the gastric mucosa; II - tumor diameter does not exceed 5 cm, penetrates into the muscular layer of the stomach, metastases to regional lymph nodes are possible; III - a tumor larger than 5 cm, penetrates into nearby organs, and there is peripheral metastasis.

Blood chemistry

A blood test for biochemistry plays a lesser role than a general clinical test in the diagnosis of cancer. This is due to the fact that in the initial stages of cancer, almost all biochemical indicators of a person are normal, except for an increase in C-reactive protein. But this indicator is nonspecific and can increase in many conditions - systemic rheumatic diseases, infections and any inflammatory process.

Liver transaminases are almost always normal, except for liver and gallbladder tumors. In these types of cancer, ALT, AST, and bilirubin may increase. Creatinine may be elevated in stomach cancer and pancreatic cancer.

Symptoms of stomach cancer

1. Typical symptoms for gastric pathology:

• Periodic aching dull pain in the epigastric region, often occurring after eating. If a concomitant inflammatory process occurs or the tumor penetrates into nearby organs, then the pain becomes permanent.
• Frequent nausea and vomiting, which happens when a large tumor obstructs the outlet of the stomach.
• Vomiting of food eaten the day before.
• Vomit is dark brown and black, indicating bleeding from a stomach ulcer or tumor.
• Difficult passage of food bolus through the esophagus.
• Quick satiety, feeling of fullness and heaviness in the stomach after eating.
• Heartburn, belching.

2. Signs of an already advanced disease:

• Visible increase in size of the abdomen due to the presence of free fluid in the abdominal cavity.
• Severe pallor or yellowness of the skin and mucous membranes.
• Significant enlargement of the lymph nodes on the left above the collarbone and in the axillary region.

3. Group of general complaints: weakness, increased body temperature, decreased appetite, decreased body weight, exhaustion. If the patient has similar complaints, it is necessary to urgently seek medical help. If dark brown or black vomit appears, immediate hospitalization is required.

General blood test for cancer

In a general clinical blood test, the erythrocyte sedimentation rate (ESR) primarily changes. With the development of a tumor process anywhere in the body, the adhesive properties of platelets increase, and the viscosity of blood plasma, on the contrary, decreases. Therefore, increasing ESR is the first thing you need to pay attention to.

However, this criterion should not be overestimated in differential diagnosis, since it can change in a number of other pathological processes and normally - with strong emotional experiences, diet, and so on.

The changes in the blood cell formula will also be nonspecific. In most cases of cancer, there will be an increase in monocytes and lymphocytes in the initial stages of the disease and a decrease in them in the later stages and with metastatic disease. This is due to the fact that at stages 3 and 4 of oncology, the immune and hematopoietic systems are already exhausted.

An exception is hemoblastosis - oncological diseases of the blood and hematopoietic organs (bone marrow). Thus, with lymphomas and leukemia, young and immature blood cells appear in the blood in large quantities, which are normally absent or there are single cells. This sign in the blood formula is leading and generally determining when making a diagnosis.

Indicators for blood cancer of hemoglobin, hematocrit, concentration of neutrophils and macrophages are practically of no use for detecting cancer, and their interpretation indicates an inflammatory process or other pathologies.

Diagnosis of stomach cancer

• 
  Esophagogastroduodenoscopy is the main type of diagnosis of stomach diseases and is indicated for patients over 50 years of age, as well as for people suffering from chronic gastritis or stomach ulcers. During the study, a biopsy is performed.

• X-ray examination of the stomach with contrast: informative for infiltrative growth of a cancerous tumor, when even a biopsy gives a negative result.
• Ultrasound scanning of the abdominal cavity: provides information mainly on the presence of metastases.
• Computed tomography of the abdominal cavity: makes it possible to more clearly interpret the obtained ultrasound data on the presence or absence of metastases.
• Laparoscopy: performed in unclear diagnostic cases to take a biopsy.
• Tumor markers: they are monitored in already treated patients to determine metastasis at an earlier date.

FAQ

When deciphering blood tests, patients often ask questions about how this or that indicator can change with cancer and what this can mean. Let's look at the most common of them.

Can a good blood test be detected in cancer patients?

Yes, it can if the disease is detected in the initial stages or at the compensation stage. In addition, do not forget that there are a huge number of types of blood tests and a situation may arise that there are no changes in the general analysis, and tumor markers were not detected.

However, the situation when a general blood test for cancer does not have any abnormalities does not occur so often

Is it possible to determine the stage of cancer using a blood test?

Oncology is staged based on many criteria, and most of them are purely clinical - the spread of the primary tumor, the presence of metastases in the lymph nodes and nearby organs, and so on. Therefore, if it is possible to draw a parallel with the stage using a blood test, then it is very approximately, and such an analysis should be highly specific, such as genetic tests or determination of tumor markers.

Is there a specific test to detect stomach cancer?

Stomach tumors cannot be detected by analyzing general blood tests. However, today there are innovative molecular tests that make it possible to determine gastric cancer and its antigenic set. This is the detection of PEA-1 tumor markers and the Foundation One genetic test, which completely determines the antigenic profile of a cancer cell. This test will show the cancer itself and determine its aggressiveness.

These tests are not carried out in all clinics in the world and are expensive. At the First Tel Aviv Medical Center, the patient has the opportunity to order all the latest genetic and molecular tests.

Can a blood test detect cancer?

Most often, even general and biochemical blood tests will show changes in indicators in the presence of cancer. However, this does not always happen and these changes may be associated with other reasons - infections, stress, and so on.

Identification of specific tumor markers is a more specific criterion, but they can also be elevated in related pathologies. But innovative genetic tests will always give an answer - what type of tumor led to the changes, whether it is treatable and show the degree of aggressiveness of atypical cells.

However, such tests are not performed in the CIS countries, so the answer to the question is no, there is no general test that determines cancer in the blood.

What tests should I take for blood cancer?

For hemoblastoses, the most effective will be a general blood test with a formula of cellular elements and a detailed biochemical analysis with the identification of tumor markers NSE and CEA-5

Deciphering a blood test for bone marrow cancer

In this situation, the general analysis will include immature cells and progenitor cells that are not normally found in the blood. During a tumor process in the bone marrow, they do not have time to develop to mature forms, enter the bloodstream and cease to perform their function

Treatment of stomach cancer

Only surgical treatment is effective. It involves several different operation options:

• Removal of part of the stomach, so-called resection.
• Gastrectomy - complete removal of the stomach.
• Combined advanced operations. Resection of parts of nearby organs is also provided.
• Extending the gastrostomy tube onto the anterior abdominal wall. It is practiced in inoperable situations to maximally prolong the patient’s life.
• Formation of a bypass connection between the stomach and intestinal loops. It is performed in inoperable situations to maximally prolong the patient’s life.

In addition to surgery, antitumor treatment is carried out, which includes:

• Chemotherapy.
• Radiation therapy when it is not possible to completely remove the tumor.

Patient survival reaches 80-90% at stage I of tumor growth. At all other stages the prognosis is doubtful.

Essential drugs

There are contraindications. Specialist consultation is required.

• Etoposide (antitumor drug). Dosage regimen: IV, at a dose of 120 mg/m2 on days 1–3. The interval between courses is 3 weeks.
• Cisplatin (antitumor drug). Dosage regimen: IV, at a dose of 80 mg/m2 on the 1st day. The interval between courses is 3 weeks.

Incidence (per 100,000 people)

What to do if you suspect stomach cancer

• Analysis for CA 125

  A CA 125 level above 100 units/ml may be a sign of stomach cancer.

• Analysis for CA 19-9

  An increase in CA 19-9 (carbohydrate antigen 19-9) above 500 U/ml can be observed in gastric cancer (90%).

• Blood chemistry

  With stomach cancer, a decrease in serum glucose levels (hypoglycemia) may occur.

• Fecal occult blood test (Gregersen test)

  A positive stool reaction to occult blood can be observed with stomach tumors in the decay stage.

• AFP analysis

  Elevated AFP compared to normal AFP units in men and non-pregnant women may indicate gastric cancer.

• Analysis for CEA

  In gastric cancer, the level of CEA (carcinoembryonic antigen) is increased (90%).

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What are the types of blood tests?

All types of blood tests are divided into:

• general clinical analysis. Shows hematocrit (colored blood indicator), hemoglobin level, erythrocyte sedimentation rate and blood formula (concentration of blood cells in plasma).
• Blood chemistry. It examines such biochemical markers as liver transaminases (ALT, AST), bilirubin, creatinine, total plasma protein, C-reactive protein and, if necessary, glucose.
• Hormonal profile analysis. The concentrations of various hormones are studied - the thyroid gland, pituitary gland, adrenal glands, and so on. In order to determine how much it will cost to treat the pituitary gland in Israel or the thyroid gland, a blood test is an integral procedure.
• Blood clotting test or coagulogram. Among the indicators are thrombocytes, the concentration of blood clotting factors and the time of formation of conglomerates.
• Determination of the Rh factor and blood groups using erythrocyte antigens.
• Serological blood tests. The presence of antibodies to certain infectious agents is examined - for example, hepatitis C, HIV, etc.
• Determination of various tumor markers in the blood. At the moment, dozens of specific biochemical markers are known that are inherent in one or another type of oncology - intestinal cancer, breast cancer, and so on.
• Innovative genetic tests. In developed Western countries, special tests are carried out on the genetic profile of a cancer cell, which makes it possible to identify the type of tumor, its resistance to treatment and the risk of subsequent relapses.
• To determine thyroid cancer, the blood is tested for thyroid-stimulating hormone levels. If the disease is confirmed, the support service will contact you and you will be able to find out the exact prices for treatment of thyroid carcinoma in Israel.

So, can a blood test detect cancer? With a high degree of probability it is possible if you use methods appropriate to the situation (signs of the disease, stage). Now let’s look at what different types of tests look like for cancer.

Symptoms