Patient : The patient is my father, who used to have a long-term bad stomach and was examined for contracted gastritis, and later examined for superficial gastritis; in June this year, he underwent minimally invasive surgery for a right adrenal cyst, and about 4 cm of the cyst was removed, and the doctor said it was benign. Pre-operative examination revealed a premature heartbeat. Meanwhile, there was a small cyst in the left kidney, which had a history of several years and was not treated because it was not large. Three months after the operation, there has been a slight pain around the incision and occasional pain from pins and needles, but when I consulted the doctor, he said it was normal. In September this year, the ultrasound showed that the right kidney was normal and the left kidney had two cysts, one about 1cm and the other about 2cm; at the same time, a blood test was done to detect the tumor factor, and a week later the result showed that the index of “carcinoembryonic antigen-CEA” was abnormal, 10.345ng/ml (normal reference value). The result showed that the index of “carcinoembryonic antigen-CEA” was abnormal at 10.345ng/ml (normal reference value should be 05345ng/ml), while other indexes were normal. The doctor suggested to check this indicator again a week later, so I changed the hospital and checked again a week later, and the result was 11.14ng/ml, still high. I consulted with several local doctors, but they had different opinions, some said it was related to surgery, some said it might be inflammation of the pancreas, but the ultrasound of the liver, gallbladder, spleen, pancreas and kidney did not find any problems with the pancreas. Can it really be related to surgery? My father has worked hard all his life and I hope he will live a long and healthy life, so I am very worried. Doctor : 1. Is the preoperative CEA indicator normal? 2.Checking pancreatic CT effect is better than color ultrasound. 3. We recommend colonoscopy if conditions permit. Patient: Thank you, doctor. I didn’t check the CEA index before the operation, but I decided to listen to your advice to do pancreatic CT and colonoscopy in the near future, and I will ask for your guidance when I have the results. Thank you! Patient: Thank you for your guidance last time. According to your advice, I have already done pancreatic CT and colonoscopy for my father, as well as chest CT, gastroscopy and small bowel imaging. Briefly introduce the examination results (provided by Daqing Oilfield General Hospital): CT film results: old tuberculosis has calcified, emphysema is more serious, there are several nodules under the pleura, poor liver absorption, bad gallbladder, a cyst in the left kidney (it was there before), no abnormality in the pancreas. Gastroscopy results: erosive gastritis with atrophy, did a section pathology results for chronic gastritis. Colonoscopy result: two polyps in the colon 30cm from the anus, section was done and the pathology result was tubular adenoma. Small intestinal angiography: no abnormalities. Biochemical blood test: liver function and kidney function were normal. I don’t know if the CEA of carcinoembryonic antigen in the last test is related to one or more of the diseases detected in this test, and I am worried about emphysema and colonic adenoma. Is surgery necessary for adenoma of the colon? Can they be treated conservatively? If surgery is necessary, what type of surgery is appropriate for this patient (he has sinus arrhythmia, premature heartbeat, and sometimes cardiac arrest, and he just had a minimally invasive adrenal cyst surgery in June)? What is the treatment for the other diseases detected in this examination? I have a lot of questions, so I’m asking you, Professor Joe! This is purely out of the concern of my children, my father has had a difficult life, and I hope he can live a long and healthy life as a child. Doctor : Generally speaking, CEA (carcinoembryonic antigen) is one of the most important tumor screening markers, and abnormal elevation is often seen in patients with a specific malignancy, such as some rectal and colon cancers, stomach cancer, and even lung cancer and breast cancer, but it is not a specific diagnostic indicator. However, it is not a specific diagnostic indicator. In other words, elevated CEA alone cannot make any diagnosis, but can only be a “reminder”. From the current test results, it can be rechecked in a month. In addition to tumors, we have also seen some patients with inflammatory diseases with elevated CEA, which is also around 10ng/mL. Given the current condition of the old man, it cannot be ruled out that such test results are due to diseases such as emphysema. The first priority is to stabilize cardiopulmonary function! Both atrophic gastritis and colonic adenoma also need attention, but slow recuperation and regular review is good, although there is a cancer rate, the current condition certainly does not require surgical treatment, and gastroenterology may be able to do enteroscopic electrodesis. Please refer to the opinions of cardiovascular, respiratory and gastroenterology departments. Please also refer to the opinions given by other doctors, and do not miss the possibility that we overlooked. May the old man regain his health soon.