Time and content of post-operative review of lung cancer
Note: Patients with postoperative chemotherapy or oral targeted drugs need to have routine blood tests and liver and kidney function for each review.
1 month after surgery: chest CT, blood routine, liver and kidney function and tumor markers.
Every 3-6 months for 2 years after surgery
3 months chest CT, abdominal ultrasound (liver, gallbladder, pancreas, spleen, adrenal gland), tumor markers.
6 months chest CT, abdominal ultrasound (liver, gallbladder, pancreas, spleen, adrenal gland), cranial CT, bone scan (ECT), tumor markers.
9 months CT of chest, ultrasound of abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), tumor markers.
12 months CT chest, ultrasound abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), CT head, bone scan (ECT), tumor markers.
15 months CT of chest, ultrasound of abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), tumor markers.
18 months CT of chest, ultrasound of abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), CT of head, bone scan (ECT), tumor markers.
21 months CT of chest, ultrasound of abdomen (liver, gallbladder, pancreas and spleen, adrenal gland), tumor markers.
Semi-annual review 2-5 years after surgery
24 months chest CT, abdominal ultrasound (liver, gallbladder, pancreas, spleen, adrenal gland), cranial CT, bone scan (ECT), tumor markers.
30 months chest CT, abdominal ultrasound (liver, gallbladder, pancreas, spleen, adrenal gland), cranial CT, bone scan (ECT), tumor markers.
36 months CT chest, ultrasound abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), CT head, bone scan (ECT), tumor markers.
42 months CT chest, ultrasound abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), CT head, bone scan (ECT), tumor markers.
48 months CT of chest, ultrasound of abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), CT of head, bone scan (ECT), tumor markers.
54 months CT of chest, ultrasound of abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), CT of head, bone scan (ECT), tumor markers.
Annual review more than 5 years after surgery
60 months chest CT, abdominal ultrasound (liver, gallbladder, pancreas, spleen, adrenal gland), cranial CT, bone scan (ECT), tumor markers.
72 months CT of chest, ultrasound of abdomen (liver, gallbladder, pancreas, spleen, adrenal gland), CT of head, bone scan (ECT), tumor markers.
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What are the tumor markers for lung cancer?
Neurospecific enolase (NSE): NSE has quite high specificity and is the preferred marker for small cell lung cancer, while less than 20% of non-small cell lung cancer has elevated serum NSE, so it can be used as an indicator to distinguish small cell lung cancer from non-small cell lung cancer. In addition, NSE is significantly higher in patients with progressive lung cancer than in those with non-progressive lung cancer, and the level of NSE decreases when treatment is effective, so NSE can be used both for the diagnosis of small cell lung cancer and for monitoring treatment response.
SCC antigen: SCC has a 50% positive rate in lung squamous cell carcinoma, but less than 30% in other lung cancers, so SCC is considered a more specific marker for squamous cell carcinoma. Many squamous cell carcinoma recurrence can be seen as a “rebound” of serum SCC level, so SCC can be used as a recurrence monitor for squamous cell carcinoma. Non-malignant lung tumors may have a false positive rate of 10%-15%.
CEA: CEA can only be measured in trace amounts in normal human serum, but it has been shown that lung cancer cells can produce CEA directly, so the measurement of CEA in serum can be used as an indicator for the diagnosis of lung cancer, as well as for monitoring the response to treatment and prognosis. the value of CEA in the early diagnosis of lung cancer needs to be further investigated.
CYFPA21-1: It is a useful marker and the first marker for non-small cell lung cancer, with a specificity of 95% and sensitivity of 49%, especially for the diagnosis of squamous carcinoma, which has a higher sensitivity of 60%, and a significantly higher level of CYFRA21-1 indicates advanced tumor or poor prognosis. However, normal or slightly elevated CYFRA21-1 cannot exclude the existence of tumor. With good treatment, the level of CYFRA21-1 will drop quickly or return to normal level. If the value of CYFRA21-1 remains unchanged or slightly decreases, it suggests that the tumor is not completely removed or multiple masses exist.
CAl25: The positive rate is high in various lung cancers and can be used for treatment monitoring and prognosis assessment of lung cancer.
CA19-9: elevated in a variety of adenocarcinomas, such as pancreatic, lung, colon, rectal and gastric cancers. CAl9-9 is measured in patients on follow-up visits and can be used for treatment monitoring and prognosis assessment of lung cancer.
CAl5-3: Although it is found in breast cancer, it has a good positive rate in lung adenocarcinoma and large cell carcinoma, and can be used for treatment monitoring and prognosis assessment of lung cancer.
The detection of one tumor marker alone is often less specific and less sensitive than ideal, therefore, the combination of multiple tumor markers is often used clinically not only to improve the positive rate of lung cancer diagnosis, but also to monitor the efficacy of lung cancer and assess the prognosis of lung cancer.
The use of tumor markers can not only make differential diagnosis of lung cancer tissue types and formulate appropriate treatment plans for patients faster, but also monitor the treatment process of lung cancer patients, determine whether the treatment plan is effective and whether the treatment plan needs to be changed in time, detect tumor recurrence and metastasis at an early stage, effectively reduce patient mortality and medical costs.