1.AFP (alpha-fetoprotein) AFP is the most sensitive and specific indicator for early diagnosis of primary liver cancer and is suitable for large-scale screening. If the blood AFP value of adults is elevated, it indicates the possibility of liver cancer. Significantly elevated AFP level generally indicates primary hepatocellular carcinoma, 70-95% of patients have elevated AFP, the more advanced, the higher the AFP level, but negative does not exclude primary hepatocellular carcinoma. the AFP level to some extent reflects the size of the tumor, its dynamic changes have a certain relationship with the disease, and it is a sensitive indicator showing the treatment effect and prognosis judgment. abnormally high AFP value generally indicates An abnormally high AFP level generally indicates poor prognosis, while an increase in its level indicates deterioration of the disease. Usually, two months after surgical resection of hepatocellular carcinoma, the AFP value should be reduced to less than 20ng/ml. If the value is not reduced much or is reduced but increases again, it indicates incomplete resection or the possibility of recurrence or metastasis. In metastatic hepatocellular carcinoma, the AFP value is usually below 350-400 ng/ml. AFP may also be significantly elevated in germinal gland embryonal carcinoma and ovarian endodermal sinus carcinoma in obstetrics and gynecology. moderately elevated AFP is also common in alcoholic cirrhosis, acute hepatitis and HBsAg carriers. Some cancers of the digestive tract may also show elevated AFP. Elevated AFP in maternal serum or amniotic fluid suggests fetal spina bifida, anencephaly, esophageal atresia, or multiple births. Decreased AFP (in combination with maternal age) suggests that the unborn child is at risk for Down’s syndrome. Normal reference value: 0-15 ng/ml 2. Carcinoembryonic antigen (CEA) CEA is difficult to detect in the blood of normal adults; CEA is an important tumor-related antigen. 70-90% of colon adenocarcinoma patients are highly positive for CEA, and the positive rates in other malignant tumors are in the order of gastric cancer (60-90%), pancreatic cancer (70-80%), small intestine adenocarcinoma (60-83%) lung cancer (56~80%), liver cancer (62~75%), breast cancer (40~68%), and urological cancer (31~46%). The positive detection rate of CEA in gastric fluid (gastric cancer), saliva (oral cancer, nasopharyngeal cancer) and chest and abdominal fluid (lung cancer, liver cancer) is higher because CEA in these tumor “soaking fluid” may exist before blood. When liver metastasis occurs, the increase of CEA is especially obvious. CEA measurement is mainly used to guide the treatment and follow-up of various tumors, and the continuous observation of CEA concentration in blood or other body fluids of tumor patients can provide an important basis for disease judgment, prognosis and efficacy observation. A large number of clinical practices have confirmed that the preoperative or pre-treatment CEA concentration can clearly predict the status of tumor, survival period and the indication for surgery. The lower the preoperative CEA concentration, the earlier the stage of disease, the smaller the possibility of metastasis and recurrence, and the longer the survival time; conversely, the higher the preoperative CEA concentration, the more advanced the stage of disease, the more difficult to resect, and the poor prognosis. When surgical resection of malignant tumor is performed, continuous measurement of CEA will help to observe the efficacy. The CEA concentration can also reflect the efficacy of radiotherapy and chemotherapy. As long as the CEA concentration decreases with the treatment, it is effective; if the concentration remains unchanged or even increases with the treatment, it is necessary to change the treatment plan. CEA testing can also be used to monitor recurrence and metastasis in patients whose CEA has been normalized by surgery or other methods of treatment for a long period of time. The following protocol is usually used: once in the sixth week after surgery; once a month for three years after surgery; once every three months for three to five years; once every six months for five to seven years; and once a year after seven years. If elevation is found, measure again after two weeks; both times elevation indicates recurrence and metastasis. Normal reference value: 0-5 ng/ml 3. Cancer antigen 125 (CA125) CA125 is the preferred marker for ovarian cancer and endometrial cancer. if 65U/ml is used as the positive limit, the accuracy rate of stage III-IV carcinoma can reach 100%. CA125 is by far the most important index for early diagnosis, efficacy observation, prognosis judgment, monitoring recurrence and metastasis of ovarian cancer. The combination of CA125 measurement and pelvic examination can improve the specificity of the test. Elevated CA125 levels are a sign of recurrence of female germline tumors. The prognostic evaluation and therapeutic control of ovarian cancer can be facilitated by dynamic observation of serum CA125 levels, which can decrease significantly after treatment. In patients with metastatic ovarian cancer, serum CA125 is even more significantly higher than the normal reference value. Elevated CA125 can also be seen in ascites caused by various malignant tumors and in many benign gynecological diseases, such as ovarian cysts, endometrial disease, cervicitis and uterine fibroids, gastrointestinal cancer, liver cirrhosis, hepatitis, etc. Normal reference value: 0.1~35 U/ml. 4.Cancer antigen 15-3 (CA15-3) CA15-3 is the most important specific marker for breast cancer. 30%-50% of breast cancer patients have significantly elevated CA15-3, and the change of its level is closely related to the treatment effect, which is the best indicator for breast cancer patients to diagnose and monitor postoperative recurrence and observe the efficacy of treatment. Dynamic measurement is helpful for early detection of recurrence after treatment in stage II and III breast cancer patients; when CA15-3 is greater than 100 U/ml, it can be considered as having metastatic lesions. Serum CA15-3 can also be elevated in patients with lung, gastrointestinal, ovarian and cervical cancers, and should be differentiated, especially to exclude the elevated levels caused by some pregnancies. Normal reference value: 0.1-25 U/ml 5. Cancer antigen 19-9 (CA19-9) CA19-9 is a marker related to pancreatic cancer, gastric cancer, colon and rectal cancer, and gallbladder cancer, and numerous studies have proved that CA19-9 concentration is related to the size of these tumors, and is the most sensitive marker for pancreatic cancer reported so far. It is positive in 85% to 95% of patients with pancreatic cancer. CA19-9 measurement helps in the differential diagnosis and disease monitoring of pancreatic cancer. When CA19-9 is less than 1000 U/ml, it has some surgical significance. CA19-9 concentration will decrease after tumor removal, and if it rises again, it can indicate recurrence. There is also a high positive rate for the diagnosis of pancreatic cancer metastasis. When the serum CA19-9 level is higher than 10,000 U/ml, there is almost always peripheral metastasis. The positive rate of gastric cancer, colorectal cancer, gallbladder cancer, bile duct cancer and liver cancer will also be high, and the positive detection rate can be further increased if CEA and AFP are tested simultaneously (for gastric cancer, a combined test of CA72-4 and CEA is recommended). The concentration of CA19-9 can also be increased in benign and inflammatory lesions of the gastrointestinal tract and liver, such as pancreatitis, mild biliary depression and jaundice, but it is often “transient” and the concentration is mostly below 120 U/ml, which must be differentiated. Normal reference value: 0.1~27 U/ml 6. Cancer antigen 72-4 (CA72-4) CA72-4 is one of the best tumor markers for the diagnosis of gastric cancer, with high specificity and sensitivity of 28-80%. CA72-4 level has a significant correlation with the stage of gastric cancer, and generally increases in the stage III-IV of gastric cancer, and the positive rate of CA72-4 in patients with metastasis is much higher than that in non-metastatic patients. In 70% of recurrent cases, CA72-4 concentrations are elevated first. The main advantage of CA72-4 over other markers is its extremely high specificity for the differential diagnosis of benign lesions, with a detection rate of only 0.7% in a large number of patients with benign gastric disease. CA72-4 is also useful for the detection of other gastrointestinal cancers, breast cancer, lung cancer and ovarian cancer in varying degrees. CA72-4 in combination with CA125 is a marker for the diagnosis of primary and recurrent ovarian tumors with a specificity of up to 100%. Normal reference value: 0.1-7 U/ml 7. Cancer antigen 242 (CA242) CA242 is a new tumor-associated antigen whose content increases when tumors occur in the gastrointestinal tract. It has high sensitivity and specificity for pancreatic cancer and colorectal cancer, with a positive detection rate of 86% and 62% respectively, and also has a certain positive detection rate for lung cancer and breast cancer. It is used for the differential diagnosis and prognosis of pancreatic cancer and benign hepatobiliary disease, and also for the preoperative prognosis and recurrence of colorectal cancer patients. CEA and CA242 combined test can improve the sensitivity, compared with CEA alone, it can increase 40-70% for colon cancer and 47-62% for rectal cancer. cea and CA242 are not correlated and have independent diagnostic value, and they are complementary to each other. Normal reference value: 0-17 U/m 8. Cancer antigen 50 (CA50) CA50 is a marker for pancreatic, colon and rectal cancers, and is the most commonly used glycan antigen tumor marker, because it is widely present in pancreas, gallbladder, liver, stomach, colorectum, bladder and uterus, and its tumor recognition spectrum is wider than CA19-9, so it is a universal tumor marker-related antigen, not specifically for a certain organ. CA50 can be detected in various malignant tumors with different positive rates, the positive detection rate for pancreatic cancer and gallbladder cancer is the first one, accounting for 94.4%; the others are liver cancer (88%), ovarian and uterine cancer (88%) and malignant pleural fluid (80%). It can be used for the early diagnosis of pancreatic cancer, gallbladder cancer and other tumors, and also has high value for the diagnosis of liver cancer, gastric cancer, colorectal cancer and ovarian cancer. It is worth pointing out that CA50 is positive in 80% of AFP-negative hepatocellular carcinoma, and it is also more correct as an indicator of the thoroughness of surgical treatment. In addition, CA50 has a high positive detection rate for malignant pleural fluid, while there are no positive reports for benign pleural fluid, so CA50 testing is also of great value for differentiating benign and malignant pleural fluid. It has also been reported that the concentration of CA50 in gastric juice of patients with atrophic gastritis is significantly altered compared to normal subjects. It is usually considered that atrophic gastritis is a pre-cancerous high-risk stage, so CA50 can be used as one of the pre-cancerous diagnostic indicators. CA50 is also elevated at the onset of pancreatitis, colitis and pneumonia, but decreases with the resolution of inflammation. Normal reference value: 0-20 U/ml 9.Non-small cell lung cancer related antigen (CYFRA 21-1) CYFRA 21-1 is the most valuable serum tumor marker for non-small cell lung cancer, especially for early diagnosis, efficacy observation and prognosis monitoring of patients with squamous cell carcinoma.CYFRA 21-1 can also be used to monitor the course of transverse muscle infiltrating bladder cancer, especially for anticipating the recurrence of bladder cancer is of greater value. If the tumor is well treated, CYFRA 21-1 levels will quickly decline or return to normal levels, and changes in CYFRA 21-1 values often precede clinical symptoms and imaging during the progression of the disease. The specificity of CYFRA 21-1 for differentiation from benign lung diseases (pneumonia, tuberculosis, chronic bronchitis, bronchial asthma, emphysema) is relatively good. Normal reference value: 0.10-4 ng/ml 10. Small cell lung cancer-associated antigen (neuron-specific enolase, NSE) NSE is considered the marker of choice for monitoring small cell lung cancer, and is elevated in 60-80% of patients with small cell lung cancer. In remission, 80-96% of patients have normal NSE levels, and if NSE is elevated, it suggests recurrence. Within 24-72 hours after the first round of chemotherapy in patients with small cell lung cancer, NSE is transiently elevated due to the breakdown of tumor cells. Therefore, NSE is an effective marker for monitoring the efficacy and course of small cell lung cancer and can provide valuable prognostic information. NSE can also be used as a marker for neuroblastoma and has high clinical application for the early diagnosis of this disease. Patients with neuroblastoma also have elevated urinary NSE levels, and serum NSE levels decrease to normal after treatment. The measurement of serum NSE levels is an important reference value for monitoring the efficacy of neuroblastoma and predicting recurrence, and is more meaningful than the measurement of urinary catecholamine metabolites. It is also important for the diagnosis of amine precursor uptake decarboxylation cell tumor, seminoma and other brain tumors. Normal reference value: 0~16 ng/ml