肿瘤标志物仔细诠释攻略！
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1、</span>肿瘤标志物是什么？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤标志物（tumor marker；TM），学术上<span style="color: black;">一般</span><span style="color: black;">指的是</span>在恶性肿瘤的<span style="color: black;">出现</span>和增殖过程中，由肿瘤细胞本身所产生的或<span style="color: black;">是由于</span>机体对肿瘤细胞反应<span style="color: black;">反常</span>产生/<span style="color: black;">上升</span>的，反映肿瘤存在和生长的一类物质。<span style="color: black;">包含</span>蛋白质、激素、酶等等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">通俗一点<span style="color: black;">来讲</span>，就像是肿瘤细胞在你的身体里和你打仗，<span style="color: black;">没</span>论是打赢了还是打输了总要留下点“战争的痕迹”，以此来彰显它的存在。正是它的“虚荣心”出卖了它的行踪，留下了“肿瘤标记物”。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2、</span>肿瘤标志物<span style="color: black;">上升</span>就<span style="color: black;">表率</span>得了癌症？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">无</span>肿瘤的人，肿瘤标志物<span style="color: black;">亦</span>可能会<span style="color: black;">上升</span>。<span style="color: black;">尤其</span>当肿瘤标志物轻度<span style="color: black;">上升</span>时，可能是<span style="color: black;">身体</span>存在<span style="color: black;">有些</span>非肿瘤性的其他<span style="color: black;">疾患</span>。<span style="color: black;">例如</span>：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大姨妈</span>期、妊娠<span style="color: black;">初期</span>血清 CA125 可<span style="color: black;">升高</span>；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">妊娠期 CEA 可轻度<span style="color: black;">上升</span>，AFP <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;">肝肾功能<span style="color: black;">反常</span>、胆道梗阻和炎症感染等均可<span style="color: black;">导致</span>肿瘤标志物，如 CEA、CYFRA 21-1、SCC、ProGRP 等浓度<span style="color: black;">升高</span>；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肝硬化、慢性活动性肝炎、结核、子宫内膜异位症<span style="color: black;">病人</span> CA125 可<span style="color: black;">上升</span>；</p>胆汁淤积能<span style="color: black;">引起</span>血清 CA19-9 浓度<span style="color: black;">升高</span>。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤标志物升得越高，恶性可能就越大么？</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>几倍、十多倍、几十倍，当然比只<span style="color: black;">上升</span>一点点、<span style="color: black;">上升</span>一倍更有<span style="color: black;">道理</span>，但<span style="color: black;">亦</span>并非绝对。<span style="color: black;">例如</span>，有些慢性肝炎AFP可高达1000ug/L以上（正常<30ug/L），但<span style="color: black;">加强</span>磁共振<span style="color: black;">无</span><span style="color: black;">发掘</span>肝脏肿块，<span style="color: black;">况且</span>AFP随着肝功能好转而下降，就<span style="color: black;">能够</span>排除肝癌。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span>，肿瘤标志物<span style="color: black;">上升</span>还需结合临床综合判断。（<span style="color: black;">重点</span><span style="color: black;">经过</span>临床影像<span style="color: black;">检测</span>，要找到肿瘤存在的客观依据<span style="color: black;">才可</span>确诊！）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3、</span>肿瘤标志物正常能排除癌吗？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">既然肿瘤标志物<span style="color: black;">上升</span><span style="color: black;">不可</span><span style="color: black;">表率</span>得了癌症，那反过来，肿瘤标志物正常能<span style="color: black;">不可</span>说明<span style="color: black;">无</span>癌症呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">实质</span>上即便得了肿瘤，<span style="color: black;">亦</span>并<span style="color: black;">不可</span><span style="color: black;">保准</span>肿瘤标志物检测结果100%是高的。<span style="color: black;">亦</span><span style="color: black;">便是</span>说，肿瘤标志物阴性，<span style="color: black;">亦</span><span style="color: black;">不可</span>完全排除<span style="color: black;">关联</span>肿瘤。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>在肝癌病人中，肝癌标志物甲胎蛋白（AFP）的阳性率仅为79%~90%，10%～30%的原发性肝癌<span style="color: black;">病人</span>指标正常或<span style="color: black;">仅有</span>轻度<span style="color: black;">上升</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤细胞在<span style="color: black;">身体</span>发展初期，很难被检测到，<span style="color: black;">仅有</span>当肿瘤细胞分泌出来蛋白分子，<span style="color: black;">咱们</span><span style="color: black;">才可</span>在血液里检测到，这个“时间差”可能有三四个月。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另外</span>，有些癌型不分泌蛋白分子，就更难被“<span style="color: black;">捉捕</span>”了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">实质</span>上动态观察肿瘤标志物更<span style="color: black;">要紧</span>。<span style="color: black;">尤其</span>是肿瘤标志物<span style="color: black;">上升</span>幅度不大的<span style="color: black;">状况</span>下，动态观察它的变化趋势更有价值，<span style="color: black;">通常</span>1～2个月复查一次该肿瘤标志物，并有必要做其它<span style="color: black;">相关</span>的肿瘤标志物检测。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>肿瘤标志物逐步<span style="color: black;">升高</span>或<span style="color: black;">连续</span><span style="color: black;">升高</span>，或<span style="color: black;">显现</span>其它肿瘤标志物<span style="color: black;">亦</span><span style="color: black;">升高</span>，有必要在3个月后，再行影像学或胃肠镜<span style="color: black;">检测</span>，或更<span style="color: black;">精细</span><span style="color: black;">检测</span>。<span style="color: black;">由于</span>在初期不<span style="color: black;">必定</span><span style="color: black;">发掘</span>小的肿瘤，经过3个月<span style="color: black;">成长</span>后，就有可能被<span style="color: black;">发掘</span>了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>多次复查，结果大致保持稳定，<span style="color: black;">无</span>一次比一次<span style="color: black;">上升</span>（<span style="color: black;">准许</span>小幅度上下波动），或肿瘤标志物逐步下降，那<span style="color: black;">一般</span><span style="color: black;">暗示</span>它不是癌症<span style="color: black;">导致</span>的，<span style="color: black;">亦</span><span style="color: black;">便是</span>说这个指标跟癌症<span style="color: black;">无</span>直接关系。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">4、</span>不同细胞<span style="color: black;">源自</span>的肿瘤标志物种类大有不同</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因为</span>不同脏器的细胞<span style="color: black;">源自</span>和属性不同，所形成的的肿瘤标志物<span style="color: black;">亦</span>是不尽相同的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span>，当健康人群<span style="color: black;">显现</span>某一肿瘤标志物的<span style="color: black;">反常</span><span style="color: black;">上升</span>时，<span style="color: black;">咱们</span><span style="color: black;">能够</span>寻找到相应的“患病脏器”；在肿瘤<span style="color: black;">病人</span>治疗过程中，<span style="color: black;">显现</span>某一<span style="color: black;">反常</span>指标<span style="color: black;">上升</span>时，<span style="color: black;">亦</span>能提示有“转移”或“新发癌症”类型的存在。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">而即使同一脏器，肿瘤起源细胞<span style="color: black;">亦</span>可大不相同。<span style="color: black;">例如</span>肺癌，<span style="color: black;">能够</span><span style="color: black;">包括</span>起源于腺泡细胞肺腺癌，<span style="color: black;">伴同</span>CEA指标的<span style="color: black;">上升</span>；<span style="color: black;">亦</span><span style="color: black;">能够</span>起源于支气管鳞状上皮细胞的肺鳞癌，<span style="color: black;">伴同</span>SCC指标的<span style="color: black;">上升</span>；<span style="color: black;">亦</span><span style="color: black;">能够</span>起源于支气管粘膜上或腺上皮的嗜银细胞的小细胞肺癌，<span style="color: black;">伴同</span>NSE指标的<span style="color: black;">上升</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">不同肿瘤标志物的<span style="color: black;">上升</span>还有助于<span style="color: black;">咱们</span>“病理类型”的诊断。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当一位肺腺癌的<span style="color: black;">病人</span>在<span style="color: black;">长时间</span>靶向治疗后，<span style="color: black;">显现</span>了NSE和Cyfry21指标的<span style="color: black;">上升</span>，提示可能<span style="color: black;">显现</span>“小细胞肺癌”的类型转化。而混合型肿瘤<span style="color: black;">病人</span>，<span style="color: black;">常常</span><span style="color: black;">同期</span>兼具不同肿标的<span style="color: black;">同期</span><span style="color: black;">上升</span>。<span style="color: black;">因此呢</span>，学会<span style="color: black;">诠释</span>肿瘤标志物，对<span style="color: black;">咱们</span>的肿瘤治疗非常有实用价值。</p>
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