“How can I detect a tumor at an early stage?” “I have an elevated marker for this tumor, what tests should I do?” With the increasing popularity of health checkups, doctors are often asked this way. Ms. Wang is more than half a century old and has a regular life, regular medical checkups and no bad habits. After this year’s medical checkup, she found that her glycoantigen CA125 index was almost twice the upper limit, and when she checked online, she found out that CA125 is an index related to gynecological tumors such as ovarian cancer, so her heart suddenly got heavy. Ms. Wang quickly came to the hospital and was clearly diagnosed with chronic pelvic inflammatory disease and ovarian cysts after ultrasound examination. After one month of corresponding symptomatic treatment, the CA125 index was reduced to normal after re-checking, and Ms. Wang’s face once again showed a comforting smile. Today, I will tell you how to understand “tumor markers” correctly. 1.Increased tumor markers are not equal to cancer. Serum tumor markers are substances characteristically present in malignant tumor cells, or produced by abnormal malignant tumor cells, or produced by the host’s stimulation response to tumor, which can reflect the process of tumor development and monitor the response of tumor to treatment. Elevated serum tumor markers may be caused by various reasons. For example, AFP (alpha-fetoprotein) may be elevated in pregnancy, active hepatitis and reproductive tumors, in addition to primary liver cancer; sometimes there are false positives due to different testing instruments or reagents, and the details should be determined clinically. Therefore, elevated tumor markers do not necessarily mean that you have cancer. 2.Not every cancer patient has high tumor markers Although the elevated markers of malignant tumors have aroused people’s vigilance and enabled timely intervention in some early cases, it is worth noting that not every cancer patient has elevated tumor markers. For example, some patients diagnosed with advanced ovarian cancer have always had normal CA125 and no significant changes before and after surgery. There are several types of tumor markers that are more sensitive, for example, 70%-90% of primary liver cancers have elevated AFP, and the overall positive rate of PSA in prostate cancer is about 70%. Its helpful for early detection of these two tumors, but there is no tumor marker that is 100% sensitive. For those with mild elevation of a single tumor marker, there is no need to panic. If possible, try to review all the common markers. Once there are malignant tumors in the body, there may be several abnormal markers. If the value after review has been maintained at the critical level of the upper reference value, it is not significant. Tumor marker positive should be actively investigated. Tumor marker detection is an effective method for early detection of asymptomatic microfocal tumor, which can be detected before X-ray, ultrasound, CT and other examinations, but tumor marker positive is not necessarily a tumor, but only a hint and signal, which is a high-risk group and should be noticed. Similarly, a positive marker does not mean that one can rest on one’s laurels and ignore it. Those who have a positive marker should actively investigate the cause and review whether there are bad habits in their own life and impose effective health interventions, which may be reversed after correction, such as multiple strong positive markers should undergo in-depth clinical examination for early detection and treatment. 4. The following three conditions should be given special attention: (1) a single examination is particularly significant, several times higher than the upper limit of the normal value; (2) repeated examinations, the value of dynamic and continuous increase; (3) there is a familial genetic history, tumor markers increase during tumor screening. In the first two cases, the most common disease of that marker is checked first. For example, if CA724 is elevated, you can check whether there is any disease of gastrointestinal tract first, and if there is no abnormality in gastrointestinal tract, you also need to check liver, esophagus, breast, uterus and adnexa. If there is a family history of hereditary disease, if tumor markers are elevated, even if there are no symptoms and signs, it is necessary to review and follow up. Unlike CT and B-ultrasound, which can be mutually recognized in the same city, it is recommended that patients who need to be followed up should choose the same hospital or the same clinical laboratory as much as possible. Because the international standardization of tumor markers has not been perfected yet, the results of the same marker may be different when different hospitals use different methods and reagents to test the same marker; the test results obtained by different manufacturers of testing reagents and instruments may also be different; different antibody markers used for reagents, different calibrators, and differences in selectivity of analytical instruments may all lead to differences in test results. Therefore, the test results of different hospitals often lack comparability. It is important to choose the same hospital for long-term follow-up monitoring of markers so that doctors can make more accurate judgment. 6.Tumor markers can judge the treatment effect and prognosis Tumor markers are widely used to judge the efficacy of malignant tumors and become one of the powerful bases for choosing treatment plan. The content of markers is closely related to the malignancy degree, metastasis and recurrence of tumor. In clinical practice, the level of markers after the initial treatment has achieved efficacy is used as a specific “individual reference value” to determine the efficacy according to its dynamic change. Marker testing helps physicians to select individualized treatment plans for tumor patients in a timely manner.