Tumor markers rise 50 times, million did not expect this is the reason! The Inspection Section must be vigilant...

!---- 50 years ago, tumors were a little-known disease, but today, women and children are known.tumor has developed into a serious harm to people's lives of the common disease, multiple morbidity, concentric cerebrovascular disease, depression together known as the "world's three deaths."tumor markers in the early diagnosis of tumors, efficacy assessment, recurrence detection and other aspects have a greater practical value, non-high-risk groups to do tumor marker screening is often criticized, but in today's cancer color change, people do not consciously carry out this detection, suddenly encountered the abnormal rise of tumor markers, often on the human "fragile mind" has a huge impact.when the tumor marker test results do not match the clinical symptoms, the test should be back this pot? The following case 99% of people do not think that the swelling label CA724 abnormal rise behind the real reason is he! Case after a period of time, in the audit of the tumor marker report, an abnormal test results caught my attention, the patient all tumor marker testing project results are in the normal range, only CA724 as high as 350.85U / ml (Figure 1), this will not be a tumor, heart that is a pain, because my mother recently found breast lumps, fortunately finally benign lesions, but see the tumor two words on disgust.but out of the spirit of responsibility for the patient, I immediately clean up the good and bad mood, began my "chasing" process.figure one for the patient tumor marker synthase examination report case analysis first, I have the patient's serum sample, instrument status check, the patient serum no jaundice, hemolytic blood, indoor quality control, instrument status are not a big problem, in order to determine the accuracy of the results, I also took the patient's serum sample to another Roche instrument for review, the results are not different, is the patient really tumor? Confused when suddenly thought that the hospital for our department opened a clinical medical records query function, so I opened the patient's medical records, carefully browse the relevant information.medical records (1) general situation and the main complaint: patients, male, 54 years old, 12 years ago no obvious cause of left foot 1 toe joint pain, redness, no break, improve the relevant examination after diagnosis as "gout, 1 day ago patients have no obvious cause of right foot 1 toe joint pain, accompanied by redness, after the activity of the pain is aggravated, is now seeking further medical treatment in my hospital."patients have been with diabetes for 14 years and have poor blood sugar control.(2) Clinical diagnosis: gout, type 2 diabetes, hypertension level i, hypothyroidism.I also looked at the patient's imaging test, and all imaging tests were negative.'s weird, isn't it a tumor? What is the cause of CA724 increase? Thinking of the rapid conversion process, suddenly thought will it be patients for a long time to take Reishi spore powder? Reishi spore powder is a health care product, with anti-inflammatory, anti-tumor, enhance the role of immunity, I have found such a case ("the rise of the swollen label scared people half dead, it is strange!" It won't really be so clever, the heart secretly steals joy, but after communicating with patients, this reason is also PASS dropped, at this time, the air becomes stagnant, the heart of a mess, do it? That's how you send out the report? No, a voice from the bottom of my heart told me I couldn't do it, and I had to find the real reason.continue to "pursue", I put the patient recently eat food and medicine have been literature search, did not find the substances that may affect the expression of CA724, in order to more comprehensive understanding of the patient's information, I once again carefully browsed the patient's medical records information, when again see the clinical diagnosis, the eye-catching "gout" two words printed into my eyes, why say so? Because I wrote in the above article mentioned that some benign diseases can affect CA724 abnormal rise, which includes "gout", but at that time because of different focus, there is not too much attention.but is it "gout" that affects CA724 expression? Could it be the effect sefactory of the other three diseases? How big is the impact? What are the specific mechanisms? I did not know, so I quickly inquired about the relevant literature.literature reports show that some gout patients serum gedit antigen CA724 abnormally increased, up to 500 U/ml, and the number of cases is not in the minority, then I also looked at the patient's uric acid level (Figure 2), from the figure can be observed that the patient uric acid from 2014-2020 has been high level, this result confirmed the cause of gout.Figure 2 is the blood uric acid level (unit: umol /L) in patients 2014-2020, the possible mechanism is also described in the literature: (1) gout is a metabolic disease characterized by hyperuric acid emis, the most common clinical manifestations of which are recurrent acute monoarthritis, and the incidence of gout and kidney stones significantly increased.(2) Studies have shown that in addition to tumor cells, inflammatory cells can also produce tumor markers.its possible mechanisms are the deposition of urate and the formation of gout stone through some mechanism to promote local fine CA724 high expression and release, but the specific mechanism is still conclusive, need further research. but there is a question poured into the heart, why the patient uric acid has been in high value, so ask the clinician, the doctor's answer is the acute attack of gout to treat the disease, appropriate rest, pain relief mainly, until the acute attack period, actively the cause of treatment. also communicated with patients, from the patient's answer to learn that the patient's irregular medication and eating habits caused a sustained high level of uric acid. finally communicated with the clinician to inform them that the abnormal increase in CA724 levels was caused by gout, and told the patient not to be nervous, this increase is a benign increase, not a tumor occurred in one part of the body. in the end, our journey of pursuit greatly reduces the psychological burden of patients, but also for clinicians to solve the urgent need. in-depth understanding of the literature, ca724 level in the use of antigout medication, its value does not drop but there is a significant increase, indicating that drug treatment will increase ca724 level, which may be related to daffodil, pyridine, non-steroidal drugs in the body, after discontinuation, with the drug metabolism CA724 level compared to the pre-treatment significantly reduced, indicating ca724 level reflects the change of gout disease has reference value. according to the literature, I also observed the patient's CA724 and uric acid levels 5 days, 10 days, 15 days, 20 days, 30 days after discontinuation of the drug (Figure 3), and the results showed that CA724 levels also decreased significantly with the lower levelofs of uric acid and the metabolism of the drug in the body. Figure 3 is the result of the combination of uric acid (in umol/L) and CA724 (units: U/ml) expression levels after drug use, ca724 levels exceeded the normal upper limit by more than 50 times, and are the result of the combined action of disease gout and uric acid reduction drugs. CA724 changes with the change of disease and treatment of gout patients, which can provide the basis for the diagnosis of gout disease, the determination of the severity of the disease and the determination of treatment plan. finally a swollen CA724 and gout "love hate" drama came to an end. case summary CA724 does not mean that the level of CA724 in patients with a variety of benign diseases can also be increased, as seen in pancreatitis (3%), cirrhosis (4%), lung disease (17%-19%), rheumatism (21%), ovarian cysts (25%), breast disease (10%), benign gastrointestinal diseases (5%). there were also reports of abnormal lyson CA724 infections caused by the use of Reishi spore powder and Helicobacter pylori. hyperuric acid emis as the "fourth highest" after high blood pressure, diabetes, hyperlipidemia, we should attach great importance to its harm, such as: gout, arthritis, gout kidney stones, long-term hyperuric acid will also lead to acute and chronic renal failure, metabolic syndrome, insulin resistance, coronary heart disease and other important organs damage. so hyperuric acid emis is like high blood pressure, diabetes, hyperlipidemia, once the emergence of, it is necessary to actively intervene and treatment. experience when the test results and clinical symptoms do not meet, when clinicians question the test results, this pot test person can not back, we must inform the clinical test quality control of the importance, especially the pre-test factors can not control, it has an important impact on the test results; When the increase, must not review the error after the simple report, to carry out "small comprehensive" and "big comprehensive" analysis, the so-called comprehensive analysis is to test the medical professional groups of the test results and imaging, pathology and other diagnostics combined, actively and clinical communication, looking for the true cause, but also the truth. finally, to borrow the current popular sentence as an encouragement, to do a heart has fire, eyes have light, positive and enterprising test person! Source: Test Medicine Network, !-- content display ends -- !-- determine whether the login ends.