Inventory, common immunodiagnostic tumor markers

1.

AFP is the most sensitive and specific indicator for early diagnosis of primary liver cancer, suitable for large-scale screening, and if the AFP value of adult blood is elevated, it indicates the possibility

Alpha-fetoprotein is mainly synthesized from fetal liver cells and yolk sacs

Normal reference value: ≤7 ng/ml

2.

Elevated CEA is common in colorectal cancer, pancreatic cancer, stomach cancer, breast cancer, medullary thyroid cancer, liver cancer, lung cancer, ovarian cancer, and urinary tumors

A large number of clinical practices have confirmed that preoperative or pre-treatment CEA concentration can clearly predict the status, survival period and whether there are indications for

CEA testing can also provide long-term follow-up of patients who have returned CEA to normal by surgery or other methods of treatment to monitor for recurrence and metastasis

Normal reference value: ≤5 ng/ml

3.

CA125 is most commonly found in serum in patients with epithelial ovarian tumors (serous tumors) and has a higher sensitivity for diagnosis but less

Elevated

Normal reference: ≤35 U/ml

4.

Cancer antigen 15-3 is an adjunctive diagnostic indicator of breast cancer, but it is not highly

Increased: seen in breast cancer, lung cancer, colon cancer, cervical cancer, etc

Normal reference: ≤25 U/ml

5.

Serum cancer antigen 19-9 can be used as pancreatic cancer

Elevation: seen in pancreatic cancer, gallbladder cancer, stomach cancer, colon cancer, liver cancer, etc.
; Acute pancreatitis, cholecystitis, hepatitis, etc.
are also elevated
to varying degrees.

Normal reference: ≤27 U/ml

6.
Cancer antigen 72-4 (CA72-4)

CA72-4 is currently one of the best tumor markers for diagnosing gastric cancer, with high specificity for gastric cancer, its sensitivity can reach 28-80%, and if combined with CA19-9 and CEA, more than 70% of stomach cancer
can be monitored.
The level of CA72-4 is significantly correlated with the staging of gastric cancer, generally increasing in stages III.
-IV of gastric cancer, and the positive rate of CA72-4 is much higher than that of non-metastatic patients in patients with gastric cancer with metastasis
.
CA72-4 levels can rapidly decrease to normal after surgery
.
In 70% of relapsed cases, CA72-4 concentrations are first elevated
.
Compared with other markers, the main advantage of CA72-4 is that it has a high specificity for the differential diagnosis of benign lesions, and its detection rate is only 0.
7%
in many patients with benign gastropathy.

CA72-4 also has different degrees of detection rates
for other gastrointestinal cancers, breast cancers, lung cancers, and ovarian cancers.
THE COMBINATION OF CA72-4 AND CA125 IS USED AS A MARKER FOR THE DIAGNOSIS OF PRIMARY AND RECURRENT OVARIAN TUMORS, WITH A SPECIFICITY OF UP TO 100%.

Normal reference: ≤6.
9 U/ml

7.
Cancer antigen 242 (CA242)

CA242 is a new tumor-associated antigen that increases
in levels when tumors occur in the digestive tract.
It has high sensitivity and specificity for pancreatic cancer and colorectal cancer, with a positive detection rate of 86% and 62% respectively, and a certain positive detection rate
for lung cancer and breast cancer.
It is used for the differential diagnosis and prognosis of pancreatic cancer and benign hepatobiliary diseases, and also for the identification of preoperative prognosis and recurrence in colorectal cancer patients
.

The combination of CEA and CA242 can improve sensitivity, and compared with CEA testing alone, it can be improved by 40 to 70% for colon cancer and 47 to 62%
for rectal cancer.
CEA is not correlated with CA242, has independent diagnostic value, and is complementary
.

Normal reference value: 0 to 20 U/ml

8.
Cancer antigen 50 (CA50)

Cancer antigen 50 is a non-specific broad-spectrum tumor marker, which has a certain cross-antigenicity with cancer antigen 19-9, and is mainly used for the auxiliary diagnosis of pancreatic cancer, colon/rectal cancer, and gastric cancer, of which pancreatic cancer patients are the most obvious
.

Increased: seen in pancreatic cancer (up to 87% positivity), colon/rectal cancer, stomach cancer, lung cancer
.
Liver cancer
.
Malignant tumors such as ovarian cancer and breast cancer; Ulcerative colitis, cirrhosis, melanoma, lymphoma, autoimmune diseases, etc.
are also elevated
.

It has also been reported that the concentration of gastric juice CA50 in patients with atrophic gastritis has changed
significantly compared with normal people.
Atrophic gastritis is generally considered to be a high-risk precancerous stage, so CA50 can be used as one
of the diagnostic indicators of precancerous.
CA50 is also elevated at the onset of pancreatitis, colitis, and pneumonia, but decreases
with the elimination of inflammation.

Normal reference value: 0 to 20 U/ml

9.
Non-small cell lung cancer-associated antigen (CYFRA 21-1)

CYFRA 21-1 is the most valuable serum tumor marker for non-small cell lung cancer, especially for the early diagnosis, efficacy observation and prognosis monitoring of patients with squamous cell carcinoma
.
CYFRA 21-1 can also be used to monitor the course of rhabdomyosyric invasive bladder cancer, particularly for predicting recurrence of bladder cancer
.
If the tumor is treated well, the level of CYFRA 21-1 can quickly drop or return to normal levels, and the change in CYFRA 21-1 value often precedes clinical symptoms and imaging tests
during the development of the disease.

CYFRA 21-1 is more
specific in distinguishing it from benign lung diseases (pneumonia, tuberculosis, chronic bronchitis, bronchial asthma, emphysema).

Normal reference value: 0~3.
3 ng/ml

10.
Small cell lung cancer-related antigens (neuron-specific enolase, NSE)

NSE is considered the first marker of choice for monitoring small cell lung cancer, with NSE elevated
in 60 to 80% of patients with small cell lung cancer.
In remission, 80 to 96% of patients had normal NSE levels, and elevated NSE suggested relapse
.
Within 24 to 72 hours after the first round of chemotherapy in patients with small cell lung cancer, NSE is transiently elevated
due to the breakdown of tumor cells.
Therefore, NSE is an effective marker for monitoring the efficacy and course of small cell lung cancer and can provide valuable prognostic information
.

NSE can also be used as a marker of neuroblastoma, which has high clinical application value
for the early diagnosis of the disease.
Patients with neuroblastoma also have a certain increase in urine levels, and serum NSE levels drop to normal
after treatment.
The determination of serum NSE levels has important reference value for monitoring the efficacy of neuroblastoma and predicting recurrence, and is more meaningful
than the determination of metabolites of catecholamines in urine.

In addition, it is also of great significance
for the diagnosis of amine precursor uptake decarboxytoma, seminocytoma and other brain tumors.

Normal reference value: 0~16.
3 ng/ml

11.
Squamous cell carcinoma antigen (SCC)

Squamous cell carcinoma antigen (SCC) is a tumor marker with good specificity and was the first to be used to diagnose squamous cell carcinoma
.
SCC inhibits apoptosis in normal squamous epithelial cells and participates in the differentiation of the squamous epithelial layer, and participates in tumor growth in tumor cells, it helps to diagnose and monitor all squamous epithelial cell-origin cancers, such as: cervical cancer, lung cancer (non-small cell lung cancer), head and neck cancer, esophageal cancer, nasopharyngeal cancer and vulvar squamous cell carcinoma
.
SCC is elevated in the serum of these tumor patients, and its concentration increases
with the exacerbation of the disease period.
It is used clinically to monitor the efficacy, recurrence, and metastasis of these tumors and to evaluate prognosis
.

High diagnostic value for cervical cancer: sensitivity to primary cervical squamous cell carcinoma is 44% to 69%; The sensitivity of recurrent cancer is 67% to 100%, and the specificity is 90% to 96%; Its serological level is related to tumor development, degree of invasion, and presence or absence of metastases
.
Significant decrease in SCC concentration after radical cervical cancer resection; Relapse can be suggested early, and SCC concentrations increase in 50% of patients 2 to 5 months before clinical diagnosis, and can be used
as an independent risk factor.

Auxiliary diagnosis of lung squamous cell carcinoma: the positive rate of lung squamous cell carcinoma is 46.
5%, and its level is related to the degree of tumor progression, which can improve the sensitivity
of lung cancer patients with ca125, CYFRA21-1 and CEA combined detection.

Prediction of esophageal squamous cell carcinoma and nasopharyngeal carcinoma: the positive rate increases with the development of the disease, and the sensitivity can reach 73% in advanced patients, and the combined detection of CYFRA21-1 and SCC can improve the sensitivity
of the test.
The positive rate of head and neck cancer in stage III is 40%, and the positive rate increases to 60%
in stage IV.

Diagnosis and monitoring of other squamous cell carcinomas: head and neck cancer, vulvar cancer, bladder cancer, canal cancer, skin cancer, etc
.

Normal reference: < 1.
5 μg/L

12.
Total prostate-specific antigen (TPSA)

PSA is a specific marker for prostate cancer and is currently the only tumor marker recognized to have organ specificity
.
Elevated serum TPSA generally suggests a lesion of the prostate gland (prostatitis, benign hyperplasia, or cancer
).
Serum PSA is one of the most important indicators for detection and early detection of prostate cancer, and the positive cut-off value of serum TPSA quantification is greater than 10 μg/L, and the diagnostic specificity of prostate cancer is 90% to 97%.

TPSA can also be used for screening and early diagnosis of prostate cancer in high-risk populations, and is the first tumor marker
recommended by the American Cancer Society for screening prostate cancer in men over the age of 50.

TPSA measurement can also be used to monitor the condition and efficacy of prostate cancer patients or patients receiving hormone therapy, 90% of patients with postoperative prostate cancer can reduce the serum TPSA value to undetectable trace levels, if the postoperative serum TPSA value is elevated, indicating residual tumor
.
In patients with significant efficacy after radiotherapy, serum TPSA decreased to normal
within 2 months in more than 50% of patients.

Normal reference: ≤4.
400 ng/ml

13.
Free prostate-specific antigen (FPSA)

A single serum total PSA (TPSA) measurement does not clearly distinguish between prostate cancer and benign prostatic hyperplasia, mainly because there is a crossover
between the two groups of patients in the range of concentrations of 2 to 20 ng/ml.
However, FPSA/TPSA is not affected by this factor and age, and the purpose
of distinguishing prostate cancer or benign prostate hyperplasia is achieved by the FPSA/TPSA ratio.
The ratio of FPSA/TPSA in patients with prostate cancer is significantly lower, and the ratio of FPSA/TPSA in patients with benign prostatic hyperplasia is significantly higher
.
The FPSA/TPSA boundary is specified as 0.
15, below which there is a high suspicion of prostate cancer, with a diagnostic sensitivity of 90.
9%, a specificity of 87.
5%, and an accuracy of 88.
6%, which is significantly better than the TPSA alone
.

FPSA testing is mainly suitable for untreated patients with a TPSA value of 2 to 20 ng/ml, and when the TPSA value is lower than 2 ng/ml or higher than 20 ng/ml, the FPSA/TPSA ratio cannot be used to distinguish between prostate cancer and benign prostate hyperplasia
.

Normal reference value: ≤ 1.
000 ng/ml

FPSA/TPSA：> 0.
15

14.
α-L-Fucoidase (AFU)

AFU is another sensitive, specific new marker
for the detection of primary hepatocellular liver cancer.
Serum AFU activity in patients with primary liver cancer is significantly higher than that of other diseases (including benign and malignant tumors
).
The dynamic curve of serum AFU activity is of great significance for judging the therapeutic effect of liver cancer, estimating prognosis and predicting recurrence, and is even better than AFP
.
However, it is worth mentioning that serum AFU viability measurement has some overlap between some metastatic liver cancer, lung cancer, breast cancer, ovarian or uterine cancer, and even in some non-neoplastic diseases such as cirrhosis, chronic hepatitis and gastrointestinal bleeding, etc.
There is also a slight increase, and when using AFU, it should be measured simultaneously with AFP, which can improve the diagnosis rate of primary liver cancer and have a better complementary effect
.

Normal reference value: 0 to 40 IU/L

15.
EBV-VCA Antibody (EBV-VCA)

Positive EPV, family history of nasopharyngeal cancer, high incidence of nasopharyngeal cancer, and low body immunity may all be high-risk factors
for nasopharyngeal cancer.
Theoretically, a person who tests positive for EBV only means that the patient has been infected with EBV before, but whether it is the direct cause of nasopharyngeal cancer is still inconclusive
.
But in clinical practice, scientific studies have shown that positive people have a much greater
chance of developing nasopharyngeal cancer than negative people.

Clinical significance of EBV-VCA antibody: VCA-IgA ≥ 1:10 positive, indicating that it has been infected with Epstein-Barr virus (mostly half a year ago or a long time ago), and is clinically related to nasopharyngeal carcinoma, thymic lymphoepithelial carcinoma, stomach cancer, rectal cancer, rheumatoid arthritis, non-alpha-non-B hepatitis, lupus erythematosus, Sjögren's syndrome, Burkitt's lymphoma, lymphoma of immunodeficiency hosts and other diseases
。； VCA-IgM ≥ positive for 1:5 indicates that there is a recent infection, (the antibody is elevated in 2 to 3 weeks after infection, and the duration of the body varies) Clinically related to unexplained fever, fatigue, infectious mononucleosis, purpura, convulsions, Sichuan teratosis, oral peeling and other autoimmune diseases; VCA-IgG ≥ 1:80 or more, indicating that EBV is activated or activated with other viral genes and certain cellular genes, can be used as a reference for EBV or other viral infections
.

Normal reference value: negative for EBV-VCA antibodies

16.
Tumor-related substances (TSGF)

TSGF tumor-related substances combined detection (formerly known as malignant tumor-specific growth factor) is a new type of tumor marker that can be easily and quickly used for early auxiliary diagnosis of malignant tumors, and also has high application value
for efficacy observation and population examination.
Glycolipids, glycoproteins, oligosaccharides, etc.
composed of carbohydrates are widely distributed inside and outside the cell and in various body fluids, and its metabolic disorders can cause increased content in body fluids when cells become cancerous, which is an internationally recognized tumor marker; Amino acids and their metabolites are also suitable for screening due to their small tumor specificity
.
Several small molecule tumor markers are combined together to be called TSGF, and since the TSGF content is significantly elevated in the serum in the early stage of tumor, this property makes it an ideal indicator
of early adjuvant diagnosis of broad-spectrum malignancies.

TSGF is also a cancer patient treatment effect and dynamic follow-up index, clinical application data show that cancer patients before treatment TSGF detection value significantly increased, after effective treatment, the patient's serum TSGF value decreased significantly, or even dropped to normal level; In patients who do not respond to treatment or whose condition worsens, recurs, or metastasizes, the TSGF value rises
.
Therefore, TSGF has important value in the observation of efficacy, and the treatment plan can be adjusted in time according to the test results of TSGF during treatment in order to achieve the best treatment effect
.

Some acute inflammation (hepatitis, pneumonia, etc.
), autoimmune diseases such as systemic lupus erythematosus, rheumatoid and other conditions can produce cross-reactions, causing false positives
.
TSGF levels may be below the cut-off in
patients with advanced cancer.

Normal reference value: < 64U/ml is negative

17.
Ferritin (SF)

Elevated ferritin may be seen in the following tumors: acute leukemia, Hodgkin's disease, lung cancer, colon cancer, liver cancer, and prostate cancer
.
Ferritin detection has diagnostic value for liver metastatic tumors, 76% of liver metastases have a ferritin content of more than 400 μg/L, when liver cancer, AFP measurement value is low, can be supplemented with ferritin measurement value to improve the diagnosis rate
.
Ferritin is also elevated in pigmentation, inflammation, and hepatitis
.
The cause of the elevation may be due to cell necrosis, blocked erythropoiesis, or increased
synthesis in tumor tissue.

Normal reference: male: 22 to 322 μg/L Female: 13 to 150 μg/L

18.
β2-Microsphere Egg (β2-MG)

β2-MG is an adjunctive marker of malignancy and a tumor-associated antigen
on some tumor cells.
In malignant hematological diseases or other substantial canceromas, the synthesis and secretion of β2-MG by mutant cells can significantly increase the concentration in the patient's serum, especially in lymphatic tumors such as chronic lymphocytic leukemia, lymphocytic sarcoma, multiple myeloma, etc.
, and can also be seen in lung cancer, breast cancer, gastrointestinal cancer and cervical cancer
.
Because serum β2-MG can be significantly higher than normal in the early stage of tumor, it is helpful to distinguish benign and malignant tumors
.
It has been reported that the ratio of β2-MG in the ascites to the serum is significantly correlated when malignant disease is found, and if the ratio of the two is greater than 1.
3, it is considered a manifestation of
cancer.

Serum β2-MG can not only be elevated in renal failure, a variety of hematologic diseases and inflammation, but also can be increased in a variety of diseases, so it should be excluded due to certain inflammatory diseases or decreased glomerular filtration function caused by serum β2-MG increase
.
Detection of β2-MG in cerebrospinal fluid is of particular significance
for the diagnosis of meningeal leukemia.

Normal reference: 1.
58 to 3.
55 μg/ml

19.
Pancreatic embryonic antigen (POA)

Pancreatic embryonic antigen is another new, sensitive and specific new marker of pancreatic cancer, the positive rate of POA of pancreatic cancer is 95%, its serum content is greater than 20U/ml, when liver cancer, colorectal cancer, gastric cancer and other malignant tumors will also make POA elevated, but the positive rate is low
.

Normal reference value: 0 to 7 U/ml

20.
Gastrin precursor releasing peptide (PROGRP)

Gastrin precursor releasing peptide is a new marker
of small cell lung cancer.
PROGRP is a type of cerebral enterosteroid that is a precursor
to the small cell lung cancer proliferation factor gastrin-releasing peptide.

PROGRP as a marker of small cell lung cancer has the following characteristics:

1.
The specificity of small cell lung cancer is very high;

2.
Earlier cases have a higher positive rate;

3.
The blood concentration in healthy people and patients varies greatly, so the reliability of detection is very high
.

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