“医生，赶紧救救我！我得了肿瘤，不晓得是初期还是晚期啊……”40岁女子检测后坐卧不安 体检季你的这个指标正常吗？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">记者 俞茜茜 通讯员 方序 鲁青</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">编辑 潘雷 副主编 俞茜茜 金晶</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">监制 徐芳</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">最<span style="color: black;">新鲜</span>的病例在临床，最实用的健康<span style="color: black;">意见</span>来自临床<span style="color: black;">大夫</span>。浙医在线<span style="color: black;">尤其</span>开设《<span style="color: black;">大夫</span>有话说》专栏，邀请浙江省内各家医院各个科室的临床<span style="color: black;">大夫</span>亲自撰文，<span style="color: black;">诠释</span>当下健康热点，<span style="color: black;">按照</span><span style="color: black;">近期</span>临床接诊的典型病例进行健康科普，对门诊中<span style="color: black;">发掘</span>的<span style="color: black;">病人</span>在治疗或养生时出现的误区进行提醒，以及<span style="color: black;">大夫</span>对某一<span style="color: black;">疾患</span>在治疗方</span><span style="color: black;">面的思考、看法、<span style="color: black;">科研</span>等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">陈佳琦 浙大二院肿瘤内科副<span style="color: black;">专家</span>医师</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q9.itc.cn/q_70/images03/20240303/bb1e0c70266147b9846e58b2a2b0b1d1.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一位40多岁的女士，她一进诊室门就焦虑地说：“<span style="color: black;">大夫</span>，赶紧救救我吧，我得了肿瘤，不<span style="color: black;">晓得</span>是<span style="color: black;">初期</span>还是晚期啊……”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">看得出来，当时她的内心是几近崩溃的。而<span style="color: black;">引起</span>她崩溃的<span style="color: black;">原由</span>，来自一张“肿瘤标志物”的<span style="color: black;">检测</span>。<span style="color: black;">检测</span>单上赫然写着，<strong style="color: blue;"><span style="color: black;">癌糖类抗原CA125<span style="color: black;">上升</span>至40 kU/L</span></strong>。看到<span style="color: black;">这般</span>的结果，<span style="color: black;">病人</span>心里直接跟肿瘤划上了等号。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">经过仔细地问诊和筛查后，<span style="color: black;">发掘</span>她<span style="color: black;">身患</span><strong style="color: blue;"><span style="color: black;">子宫肌瘤</span></strong>，<span style="color: black;">思虑</span>她CA125的指标<span style="color: black;">上升</span>还是跟子宫肌瘤<span style="color: black;">关联</span>。经过一番<span style="color: black;">仔细</span>解释后，这位女士<span style="color: black;">最终</span>放下了心中的石头。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">门诊中，不少<span style="color: black;">病人</span>都有着和这位女士<span style="color: black;">同样</span>的焦虑。<span style="color: black;">检测</span><span style="color: black;">发掘</span>肿瘤标志物<span style="color: black;">上升</span>，从拿到<span style="color: black;">检测</span>结果就<span style="color: black;">起始</span><span style="color: black;">坐卧不安</span>了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">那是不是肿瘤标志物<span style="color: black;">上升</span>了，就<span style="color: black;">寓意</span>得了肿瘤呢？事实上，<strong style="color: blue;"><span style="color: black;">临床中肿瘤标志物只是一个监测指标，而并不<span style="color: black;">寓意</span>着就跟肿瘤划等号了</span></strong>。诚然，不同的肿瘤标志物所对应的肿瘤位置和类型是不<span style="color: black;">同样</span>的，<span style="color: black;">例如</span>癌胚抗原（CEA），就和胃肠道肿瘤以及肺腺癌等恶性肿瘤<span style="color: black;">关联</span>，<span style="color: black;">一样</span>，CA125跟妇科肿瘤，CA199跟胆道或胰腺肿瘤，AFP跟肝癌、PSA跟前列腺癌等存在<span style="color: black;">相关</span>，但这并不<span style="color: black;">寓意</span>着相应肿瘤标志物<span style="color: black;">上升</span>就对应患上了相应肿瘤。以CEA为例，除了肿瘤以外，胃肠道的息肉<span style="color: black;">或</span>炎症<span style="color: black;">亦</span>会<span style="color: black;">导致</span><span style="color: black;">上升</span>，其他肿瘤标志物<span style="color: black;">亦</span>有类似的<span style="color: black;">状况</span>，如PSA跟前列腺增生，CA125跟子宫肌瘤、子宫内膜异位等妇科<span style="color: black;">疾患</span>，CA199跟糖尿病及胆道炎症等等。总之，肿瘤标志物的<span style="color: black;">上升</span>影响<span style="color: black;">原因</span>非常多，大部分良性<span style="color: black;">疾患</span><span style="color: black;">乃至</span>生理<span style="color: black;">状况</span>都会<span style="color: black;">显现</span>肿瘤标志物<span style="color: black;">上升</span>的<span style="color: black;">状况</span>。<span style="color: black;">显现</span>肿瘤标志物<span style="color: black;">上升</span><span style="color: black;">必须</span><span style="color: black;">注意</span>，但完全<span style="color: black;">不必</span>恐慌，<span style="color: black;">遵循</span>肿瘤专科<span style="color: black;">大夫</span>的意见，后续进行随访观察或进一步的诊断，<span style="color: black;">能够</span>很好地<span style="color: black;">知道</span><span style="color: black;">原由</span>，<span style="color: black;">处理</span>问题。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q1.itc.cn/q_70/images03/20240303/d9a8861b21b24315b408e7a35190bf04.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">反之，是不是肿瘤标志物正常，就<span style="color: black;">寓意</span><span style="color: black;">能够</span>排除肿瘤呢？答案<span style="color: black;">亦</span><span style="color: black;">是不是</span>定的，<strong style="color: blue;"><span style="color: black;"><span style="color: black;">非常多</span><span style="color: black;">初期</span>肿瘤并不会<span style="color: black;">显现</span>肿瘤标志物的<span style="color: black;">上升</span>，<span style="color: black;">况且</span>部分肿瘤<span style="color: black;">亦</span><span style="color: black;">无</span>对应的肿瘤标志物，</span></strong><span style="color: black;">例如</span>恶性黑色素瘤，常用体检的肿瘤标志物就<span style="color: black;">无</span>筛查的<span style="color: black;">道理</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在肿瘤科<span style="color: black;">大夫</span>的心目中，比肿瘤标志物<span style="color: black;">上升</span>更<span style="color: black;">要紧</span>的，是</span><strong style="color: blue;"><span style="color: black;">肿瘤的规范化筛查</span></strong><span style="color: black;">。随着老龄化的产生和生活习惯改变，肿瘤的发病率确实逐步<span style="color: black;">提高</span>，<span style="color: black;">因此呢</span>，肿瘤的<span style="color: black;">初期</span>筛查至关<span style="color: black;">要紧</span>，<span style="color: black;">尤其</span>是四十周岁以上，相应的筛查就要<span style="color: black;">起始</span>了。针对胃肠癌，<span style="color: black;">意见</span>40周岁<span style="color: black;">起始</span>做<span style="color: black;">第1</span>次的胃肠镜，筛查有<span style="color: black;">无</span>胃肠道息肉<span style="color: black;">或</span>溃疡的<span style="color: black;">显现</span>，针对肺癌，2-3年一次的胸部高分辨CT筛查<span style="color: black;">亦</span>很<span style="color: black;">要紧</span>。<span style="color: black;">另一</span>，跟性别<span style="color: black;">关联</span>的，女性的乳腺癌和妇科肿瘤，<span style="color: black;">必须</span><span style="color: black;">经过</span>年度的乳腺彩超和妇科彩超进行筛查，男性的前列腺癌<span style="color: black;">能够</span><span style="color: black;">经过</span>前列腺彩超加以筛查。<span style="color: black;">一样</span>，体检套餐中还应<span style="color: black;">包括</span>甲状腺和肝胆胰的彩超，进行相应筛查。完善这一系列的早癌筛查，就<span style="color: black;">能够</span>最大程度地早筛早诊早治。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">与此<span style="color: black;">同期</span>，<strong style="color: blue;"><span style="color: black;">生活方式在肿瘤的筛查中<span style="color: black;">亦</span>有较高的位置</span></strong>，<span style="color: black;">例如</span>吸烟的人群，对肺癌的筛查就<span style="color: black;">必须</span>更加密切，有乙肝<span style="color: black;">或</span><span style="color: black;">海量</span>饮酒的人群，对肝癌的筛查就<span style="color: black;">必须</span>更加积极等等。总之，肿瘤的筛查并不是肿瘤标志物<span style="color: black;">那样</span>简单，养成良好的生活习惯，进行<span style="color: black;">定时</span>完善的肿瘤筛查，才是健康防癌的最佳<span style="color: black;">选取</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">欢迎加入</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">“肿瘤-浙医在线交流群”</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">倘若</span>您或您的亲友<span style="color: black;">亦</span>有肿瘤<span style="color: black;">关联</span><span style="color: black;">困惑</span>，欢迎扫码添加“<strong style="color: blue;"><span style="color: black;">浙医在线小助手9号</span></strong>”为好友，备注“<strong style="color: blue;"><span style="color: black;">肿瘤</span></strong>”，小助手会邀您进群。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">入群后，您<span style="color: black;">能够</span>和群友<span style="color: black;">一起</span>讨论，<span style="color: black;">咱们</span><span style="color: black;">亦</span>会不<span style="color: black;">定时</span>邀请专家进群答疑。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">“点读机<span style="color: black;">女子</span>”患脑瘤术后报<span style="color: black;">安全</span>！去年曾自曝因这个坏习惯伤了身体，<span style="color: black;">短期</span>暴瘦15斤</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">28岁姑娘接种了疫苗依旧感染上HPV！不是打了疫苗就<span style="color: black;">能够</span>高枕<span style="color: black;">没</span>忧 <span style="color: black;">定时</span>做宫颈癌筛查很<span style="color: black;">要紧</span> </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">预产期是元宵节，没想到他竟然选在今天出来了！“四年过一次生日，等这一天像等奥运会” </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">一天吃了12片，他被切掉部分胃！还有人连吃五天，多脏器衰竭！<span style="color: black;">大夫</span>紧急提醒</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">浙江男子感染上两种“要命”的寄生虫 1个月发烧3次！起因是三个月前的一趟广州行....... </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">好久没“那个”了，怎么还会感染HPV？24岁女主播查出宫颈癌后崩溃！ </p>
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