【肿瘤检测】肺癌检测单上,这些个肿瘤指标都说明了些啥?
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在这个谈癌色变的时代,部分人群已将肿瘤标志物检测<span style="color: black;">加入</span>体检项目,但肿瘤标志物<span style="color: black;">上升</span>就<span style="color: black;">寓意</span>着得了癌症吗?要<span style="color: black;">处理</span>这个问题,先来认识一下什么是肿瘤标志物。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤标志物又<span style="color: black;">叫作</span>Tumor Marker,<span style="color: black;">指的是</span>特征性存在于恶性肿瘤细胞,或由恶性肿瘤细胞<span style="color: black;">反常</span>产生的物质,或是宿主对肿瘤的刺激反应而产生的物质。<span style="color: black;">重点</span>用于肿瘤的早期<span style="color: black;">发掘</span>和筛查外,<span style="color: black;">帮助</span>诊断与分期,疗效监测等等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">非小细胞肺癌的<span style="color: black;">关联</span>标志物<span style="color: black;">重点</span>有:CEA、Cyfra21-1、 CA125、 CA153、TPA及SCC-Ag。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">CEA(癌胚抗原)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考值:<5ng/ml</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">是从儿及结肠癌组织中<span style="color: black;">发掘</span>的一种糖蛋白胚胎抗原,属于广谱性肿瘤标志物。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在肺癌中常可见<span style="color: black;">上升</span>,且胸水中CEA常高于血清。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺腺癌水平最高,肺腺癌CEA阳性率为54.2%~83.3%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在肺腺癌组中血清CEA水平与病期呈正<span style="color: black;">关联</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺腺癌<span style="color: black;">病人</span>CEA水平<span style="color: black;">明显</span>高于鳞癌及小细胞肺癌<span style="color: black;">病人</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">NSE(神经原特异性烯醇化酶)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考值:<20ng/ml</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当组织<span style="color: black;">出现</span>癌变时,细胞内的NSE释放进入血液,<span style="color: black;">引起</span>此酶在血清中含量<span style="color: black;">升高</span>,<span style="color: black;">通常</span>用于小细胞肺癌与非小细胞肺癌的鉴别诊断。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">检测小细胞癌的首选标志物,60-81%的小细胞癌<span style="color: black;">病人</span>NSE<span style="color: black;">上升</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Cyfra21-1(细胞角蛋白19)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考值:<3.3ng/ml</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">细胞<span style="color: black;">出现</span>癌变时,可释放Cyfra21-1进入血液循环,<span style="color: black;">引起</span>Cyfra21-1的血清水平<span style="color: black;">上升</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺癌中晚期<span style="color: black;">病人</span>血清中Cyfra21-1含量<span style="color: black;">显著</span><span style="color: black;">上升</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺鳞癌的首选标志物,灵敏度<span style="color: black;">达到</span>60%,特异性<span style="color: black;">达到</span>95%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺癌根治术后Cyfra21-1的浓度<span style="color: black;">明显</span>下降,若<span style="color: black;">连续</span><span style="color: black;">上升</span>,应<span style="color: black;">思虑</span>肿瘤<span style="color: black;">发展</span>和复发。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">CA125(糖类抗原125)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考值:<35u/ml</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">是由于</span>免疫卵巢癌细胞株产生的单克隆抗体OC125所识别的抗原决定簇。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺腺癌CA125水平<span style="color: black;">显著</span>高于肺鳞癌与小细胞肺癌。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">TPA(组织多肽抗原)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考值:<1ng/ml</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">用于肺鳞癌、膀胱癌、宫颈癌等鳞状上皮癌检测),多见于肺鳞癌、膀胱癌、宫颈癌等鳞状上皮癌。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">恶性肿瘤血清中的TPA水平可<span style="color: black;">明显</span><span style="color: black;">上升</span>,术前<span style="color: black;">升高</span>非常<span style="color: black;">明显</span>者提示预后不良。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">经治疗好转后再次<span style="color: black;">升高</span>者常提示复发的可能。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在肺鳞癌的诊断和预后判断方面TPA是<span style="color: black;">日前</span>最好的一项肿瘤标志物。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">SCC-Ag(鳞状上皮细胞癌抗原)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考值:<1.5ng/ml </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">是由于</span>非小细胞肺癌<span style="color: black;">尤其</span>是肺鳞癌所分泌的一种糖蛋白。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但其灵敏度较低,可<span style="color: black;">做为</span>肺癌的辅助诊断指标。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">CA153(糖类抗原153)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考值:<28ng/ml</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">存在于多种腺癌内,如乳腺癌、肺腺癌、卵巢癌及胰腺癌。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">CA153对肺癌诊断的灵敏度低下,<span style="color: black;">然则</span>,<span style="color: black;">因为</span>血清CA153测定对肺良性<span style="color: black;">疾患</span>的假阴性率低,血清CA153若<span style="color: black;">反常</span><span style="color: black;">上升</span>,则在排查掉其他肿瘤的<span style="color: black;">基本</span>上可<span style="color: black;">做为</span>肺癌诊断的<span style="color: black;">要紧</span>依据。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">最<span style="color: black;">重点</span>的几种标志物</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">CEA:肺腺癌>鳞癌、小细胞肺癌<span style="color: black;">病人</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">NSE:小细胞肺癌>腺癌、鳞癌<span style="color: black;">病人</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Cyfra21-1、 SCC-Ag:鳞癌>腺癌、小细胞癌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">CA125、 CA153:肺腺癌>肺鳞癌、小细胞肺癌</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺癌分期晚,肿瘤标志物<span style="color: black;">升高</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">与治疗有效性<span style="color: black;">关联</span>,指标<span style="color: black;">显著</span>下降提示治疗有效。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">连续</span><span style="color: black;">升高</span>的<span style="color: black;">病人</span><span style="color: black;">常常</span><span style="color: black;">存活</span>时间短,预后差。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">怎样</span>组合筛查诊断?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺腺癌:Cyfra211+CEA+TPA</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">鳞癌:Cyfra211+SCC+TPA</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">大细胞肺癌:Cyfra211+ CA125+TPA</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">没</span>法确定病理类型的肺癌:CEA+NSE+Cyfra211+ CA125</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤标志物<span style="color: black;">上升</span>不<span style="color: black;">表率</span><span style="color: black;">必定</span>得了癌症,<span style="color: black;">一样</span>肿瘤指标检测结果为阴性<span style="color: black;">亦</span>并<span style="color: black;">不可</span>完全排除癌症,<span style="color: black;">由于</span>有假阴性的存在,临床上常<span style="color: black;">经过</span><span style="color: black;">同期</span>监测多个肿瘤标志物来<span style="color: black;">做为</span>诊断肿瘤、判断预后的依据。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Care for Life生命关怀计划</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">老挝卫生部属老挝友谊医院<span style="color: black;">颁布</span>"生命关怀计划",采用老挝<span style="color: black;">已然</span>上市的国际最新<span style="color: black;">药品</span><span style="color: black;">帮忙</span>晚期和<span style="color: black;">发展</span>期癌症<span style="color: black;">病人</span>,<span style="color: black;">重点</span><span style="color: black;">包含</span>肺癌、乳腺癌、淋巴瘤、黑色素瘤、肝癌、多发性骨髓瘤等严重<span style="color: black;">害处</span>人类生命健康的<span style="color: black;">疾患</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">查看往期<span style="color: black;">更加多</span>精彩:</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><span style="color: black;">帮忙</span><span style="color: black;">更加多</span>人,乳腺癌最新治疗<span style="color: black;">方法</span>有奖调研活动正在进行</a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;">【生命关怀】老挝<span style="color: black;">颁布</span>BTK<span style="color: black;">控制</span>剂Emlutini(依鲁替尼)用于慢性淋巴细胞白</a></p>
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