Often patients are found to have elevated tumor markers after physical examination, which causes mental tension. This article is forwarded in the hope that we know the significance of tumor markers and should both pay attention to it and treat it correctly. Tumor markers are antigens and other bioactive substances generated by tumor cells in the process of carcinogenesis due to the expression of oncogenes. They can be detected in body fluids and excretion of tumor patients, while they are not produced or produced very little in normal tissues or benign diseases. The vast majority of tumor markers are only relevant, but not specific, for the diagnosis of tumors. Therefore, the combination of several tumor markers is more significant for the diagnosis of tumor. I. Combined tumor marker test program Head and neck tumor Esophageal cancer Lung cancer Stomach cancer Liver cancer Bowel cancer Breast cancer Prostate cancer Bladder cancer Ovarian cancer Cervical cancer Pancreatic cancer, bile duct cancer, gallbladder cancer Lymphoma, thymoma, leukemia, myeloma, kidney cancer, choriocarcinoma, thyroid cancer, etc. Health checkup Various tumor tests II. Tumor Markers Introduction Immunosuppressive Acidic Protein Introduction: IAP is a glycoprotein with a molecular weight of 50,000 Daltons, an isoelectric point of 3.0 and a sugar content of 31.5％ mainly produced by hepatocytes, inhibitory macrophages and granulocytes, but normal T and B lymphocytes and other cells do not produce IAP. When macrophages are stimulated by immune complexes or inflammatory factors, and when suppressive macrophages are present in the body, the amount of IAP increases significantly, and IAP has a suppressive effect on cellular and humoral immunity. IAP is not a specific tumor marker for tumor production, but a tumor-associated substance that is significantly increased when immune cells are dysfunctional and has a parallel relationship with many tumorigenesis and development. Also IAP is a parametric indicator of immune function in many patients. Clinical significance: It can be used for the detection of various tumor patients. (especially cystic cancer, neuroblastoma, leukemia, oral cancer, esophageal cancer, pancreatic cancer, ovarian cancer, lung cancer, bile duct cancer, malignant lymphoma, kidney cancer) Note: IAP levels are also increased in infectious diseases. MG7-Ag is a neutral glycolipid located in the tumor cell membrane, and the antigenic epitope is on the glycoconjugate chain, which has been confirmed by immunohistochemistry to be mainly distributed in gastric and intestinal cancers. MG7-Ag is a neutral glycolipid located in the tumor cell membrane, and the antigen epitope is on the glycan chain. Clinical significance: Diagnosis and disease detection of gastric cancer and colon cancer. MG7-Ag is also elevated in a few ovarian cancers and lung cancers. Note: MG7-Ag can also be mildly elevated in chronic atrophic gastritis, atypical hyperplasia of gastric mucosa, etc. Glycoantigen Introduction: CA19-9 is a monoclonal antibody to 116NS19-9 made by Koprowski et al. in 1979 by immunizing mice with the colorectal cancer cell line SW116 and hybridizing it with myeloma, a glycoantigen whose structure is sialylated lacto- N-fucose. Immunohistology has shown that normal human pancreas, bile ducts and gallbladder, stomach, salivary glands, prostate, breast, bronchial epithelium, endometrium, etc. have traces of CA19-9, so these organs and tissues are hyper-secreted when they are sick, especially when they have malignant tumors, and are released into the blood via tumor vessels, resulting in hyper-CA19-9emia. Serum CA19-9 assay is considered to be a tumor-associated antigen with high specificity for gastrointestinal tumors. Clinical significance: 1. Elevated CA19-9 is mostly seen in malignant diseases of the digestive system (gastric cancer, intestinal cancer, pancreatic cancer, liver cancer, bile duct cancer, etc.) and malignant gynecological diseases (ovarian cancer, etc.). CA19-9 can be elevated in both benign and malignant diseases, and its clinical significance must be determined in conjunction with clinical as well as imaging and other relevant laboratory test results. Dynamic monitoring of CA19-9 changes is important for differential diagnosis, judging the efficacy, detecting recurrence and assessing prognosis. Note: CA19-9 is also elevated to varying degrees in acute pancreatitis, cholecystitis, cholestatic cholangitis, cirrhosis, hepatitis, etc. Glycoantigen Introduction: In 1983, Bast et al. used the ovarian plasmacytoid cystic gland cell line OVCA433 as an antigen and immunized BALB/C mice with a monoclonal antibody obtained by hybridization with myeloma cells. The antigen recognized by this antibody is CA125, a large polysaccharide protein, which exists in epithelial ovarian cancer tissues and patients’ serum. CA125 is commonly found on the surface of mesothelial tissues such as pleura, pericardium, peritoneum, endometrium, etc. When malignant changes occur in these areas or when they are stimulated by inflammation, the serum CA125 content will rise significantly. Clinical significance: 1. CA125 is a marker for epithelial ovarian cancer and endometrial cancer. CA125 levels can be significantly increased in patients with plasma endometrioid carcinoma, clear cell carcinoma, fallopian tube cancer and undifferentiated ovarian cancer. CA125 levels can also be significantly elevated in lung cancer. Note: Slightly elevated CA125 serum concentrations are also seen in 1% of healthy women and 3-6% of patients with benign ovarian disorders or non-tumors, including the first trimester of pregnancy, menstruation, endometriosis, uterine fibrous degeneration, acute tubal inflammation, liver disease, thoracic peritoneal and pericardial infections. Glycoantigens Introduction: CA15-3 is a glycoprotein with a molecular weight of about 400,000 daltons. CA15-3 was only gradually used in clinical practice in the mid-1980s when Tobias et al. applied hybridoma technology to obtain monoclonal antibodies recognizing this large-molecule glycoprotein 115D8, DF3 (anti-human milk lipid globule membrane monoclonal antibody, anti-metastatic breast cancer membrane monoclonal antibody). CA15-3 belongs to polymorph CA 15-3 is expressed not only in breast cancer, but also in a range of epithelial tumors. Clinical significance: CA15-3 is important in the diagnosis of breast cancer, early diagnosis of recurrent metastases, treatment and prognostic evaluation. It is also present in the serum of patients with a variety of adenocarcinomas such as: lung, hepatocellular, intestinal, gastric, cervical, ovarian, etc. Note: Chronic renal failure, chronic liver disease with elevated GPT and induction of chemotherapy drug 5-FU or its derivatives can lead to elevated serum CA 153 levels. Glycoantigen Introduction: CA242 is a sialylated mucin type glycoantigen, whose monoclonal antibody was obtained by Lindholm et al. in 1985 by hybridoma technique using the human colon cancer cell line COLO205 immunized mice. Immunohistochemical studies found that CA242 is significantly expressed in malignant tissues such as pancreatic and colon cancer, and mildly expressed in adenocarcinomas of other organs. Clinical significance: CA242 test can be used for the auxiliary diagnosis of intestinal cancer, pancreatic cancer, gastric cancer, lung cancer, ovarian cancer, etc. Glycoantigen Introduction: CA72-4 is a high molecular weight glycoprotein complex, which belongs to the category of Lewis blood group antigen substances. The antigenic molecule disaccharide NueAc (2,6) Gal NAc includes monoclonal antibody B72 .3 made from breast cancer liver metastases as immunogen and monoclonal antibody CC49 made from TAG-72 antigen of colon cancer cells as immunogen. The monoclonal antibody CC49 recognizes the independent antigenic determinants of TAG-72. TAG-72 is a mucin-like carcinoembryonic antigen with a molecular weight greater than 1 million daltons, and histochemical studies have shown that it is present in 50％ of breast tissue and 85-95％ of colon, pancreatic, gastric, lung, and ovarian tumors, but not in leukemia, lymphoma, sarcoma, mesothelioma, melanoma, benign tumors, benign exudates, or normal in adult tissues. Therefore, it has some diagnostic and differential diagnostic significance for tumors of the pancreas, ovary and stomach. Clinical significance: Used for the diagnosis and differential diagnosis of gastric cancer, ovarian cancer, intestinal cancer, pancreatic cancer, etc. Note: It can be mildly increased in pancreatitis, chronic liver disease, lung disease, rheumatic disease, benign ovarian disease, etc. Cytokeratin 19 fragment Introduction: CYFRA21 is a fragment of cytokeratin 19, which is the main component of the cytoskeleton, and keratin peptides are the products of gene transcription. The application of bidirectional gel electrophoresis can separate 20 bands of epithelial keratin, named CK1~20, which are mainly expressed in normal human epithelial tissues CK5.6.8 .14.15 CK7, CK8, CK18 and CKl 9 are expressed in adenocarcinoma in lung cancer, and CK4, CK7, CK8, CK10, CK13, CK18 and CK19 can be measured in squamous carcinoma; small cell Lung cancer mainly expresses CK18, sometimes CK8 and CK19. It is an acidic polypeptide and the smallest keratin protein with molecular weight that was first detected in squamous carcinoma cells. It has a molecular weight of 30,000 Daltons and is mainly distributed in monolayer epithelial cells such as alveolar epithelium, trachea, esophagus and epiglottis. It is present as oligomers at very low levels when normal. When these cells are malignant, they can release CK19 fragments into the blood circulation. Clinical significance: CYFRA21-1 is the most valuable serum tumor marker for patients with non-small cell lung cancer. It can also be used as an aid in the diagnosis of bladder cancer. Note: CYFRA21-1 can be mildly elevated in benign lung diseases (pneumonia, sarcoidosis, tuberculosis, chronic bronchitis, tracheal asthma, emphysema, etc.), liver disease, renal failure, etc., generally less than 10ng/ml. Neuron-specific enolase Introduction: Glycolytic enolase is an enzyme involved in the enzymatic, catalytic conversion of 2-phosphoglycerol to phosphoenolpyruvate and consists of three subunits (α, β, and NSE consists of γ-subunit isoenzymes specifically localized in neuronal and neuroendocrine APUD cell lines (Amine Precursor Uptake and Decarboxylation Cells). α-subunit isozymes are localized in glial cells and are called non-neuronal specific enolase (NNE). NSE is a tumor marker for neuroblastoma and the most sensitive and specific tumor marker for small cell lung cancer, (small cell lung cancer is also a tumor of the neuroendocrine system with high malignancy) Clinical significance: 1. NSE is the preferred tumor marker for small cell lung cancer. It will be temporarily elevated after 24-72 hours of chemotherapy, and can rapidly decrease within two weeks in remission. No change, no decrease or elevation in those who progress. , NSE is elevated in neuroblastoma. , NSE is present in the cytosol, axon, and dendritic cytoplasm of central or peripheral neurons and can be released into the cerebrospinal fluid and blood during acute traumatic brain injury as a specific marker of neuronal injury with necrosis of neurons, disintegration of nerve myelin sheaths, and disruption of the blood-brain barrier. Note: NSE may be mildly elevated in some benign diseases of the brain and lungs. Alpha-L-amyloidase AFU (α-L – Introduction: AFU is a lysosomal acid hydrolase. In 1977, Bauer first found elevated levels of AFU in liver cancer tissues compared to normal tissues in animal experiments, and Deugnier’s report in 1984 made AFU a new indicator for detecting HCC. AFU is widely found in lysosomes of placenta, liver, pancreas, brain, kidney, fibroblasts, and human body fluids: serum, urine, saliva, and tears, etc. The main physiological function of AFU is to participate in the catabolism of various glycolipids, proteins, and oligosaccharides containing rockulose base. Because the liver is rich in lysosomes, the synthesis of the enzyme increases and degradation slows down when hepatocytes become cancerous; the enzyme is released into the blood in large quantities when tumor cells become necrotic and AFU increases. Clinical significance: AFU is used for the auxiliary diagnosis of primary liver cancer Note: Acute and chronic hepatitis, metastatic liver cancer AFU will be mildly elevated. SCC-Ag is a glycoprotein fragment purified from TA-4, a tumor-associated antigen first obtained from squamous carcinoma of the cervix by Kato and Torigoe in 1977, and consists of at least 14 substructures. SCC-Ag is one of the purified subunits and is a good marker of squamous carcinoma, initially used in the diagnosis of gynecological squamous carcinoma such as cervical and vaginal carcinoma, but later found to be abnormally high in the blood of patients with squamous carcinoma of the lung and esophagus. Clinical significance: SCC-Ag is used for the diagnosis, disease monitoring and prognosis of head and neck cancer, esophageal cancer, lung cancer, cervical cancer, etc. Note: SCC-Ag will be elevated in a few benign skin diseases. TSGF (Tumor Supplied Group of Factors) Introduction: TSGF is a newly discovered tumor marker in recent years, which is the collective name of several internationally recognized glycans and metabolites related to the growth of malignant tumors. It is released into the peripheral blood during the formation and growth of malignant tumors and can promote the proliferation of tumors and surrounding capillaries, but has no obvious relationship with the proliferation of non-tumor blood vessels, so TSGF is highly specific for malignant tumors, but has little significance for the differentiation of different tumors. Clinical significance: 1. TSGF is a broad-spectrum and sensitive tumor marker that can be used for the detection of tumors of various systems, organs and tissue sources throughout the body, especially for lung cancer, lymphoma, esophageal cancer, thymoma, pancreatic cancer, leukemia, multiple myeloma, kidney cancer, tumor metastasis or recurrence. TSGF can detect malignant tumors at an early stage, so it can be used for health screening. Note: TSGF may be elevated in some patients with infections, autoimmune diseases, diabetes, acute myocardial infarction, multiple cerebral infarction, drug-related liver damage, etc.