Tumor markers are a class of substances produced by tumor cells and present in blood, cells, tissues or body fluids that reflect the presence and growth of tumors, including proteins, hormones, enzymes and polyamines, etc. Most of the tumor markers commonly used in clinical practice are tumor-associated antigens. These markers are not specific to tumor cells, but differ in amount from normal cells due to the marked increase in expression of tumor cells. Most tumor markers are not organ-specific (broad-spectrum markers), and the same tumor may contain one or more markers, while different tumors or different tissue types of the same tumor may have both common and different markers. So far, no tumor marker with 100% sensitivity and specificity has been found. The reason is that it is not only produced when cancer occurs, but also expressed in different degrees in normal and benign disease conditions, and the production of tumor markers is also influenced by some bioactive factors. Therefore, it is difficult to make a judgment based on the detection of a certain marker or a certain test result alone. The combination of some tumor markers with higher specificity can help to improve the positive rate of tumor diagnosis; and the continuous dynamic monitoring of tumor markers will help to differentiate benign and malignant diseases, and can also indicate the recurrence and metastasis of tumor, and judge the prognosis and efficacy. For pre-cancerous patients and patients with intermediate and advanced tumors who are taking conservative treatment with Chinese medicine, monitoring related tumor markers is of great significance to observe and judge the efficacy and regression. AFP normal reference value: 0~25μg/L. Clinical significance: 1. AFP is significantly elevated in the serum of patients with primary hepatocellular carcinoma, with about 71% of patients having AFP >500μg/L. 2. AFP is elevated to varying degrees in patients with viral hepatitis and cirrhosis, but its level is often <500μg/L. 3. AFP is elevated in the serum of patients with germinal gland embryonal tumors. AFP is seen to be elevated. 4.After 3 months of pregnancy, serum AFP starts to rise and reaches a peak at 7~8 months, usually below 400μg/L, and returns to normal 3 weeks after delivery. If AFP is abnormally elevated in the serum of pregnant women, the possibility of fetal neural tube defect malformation should be considered. II. Carcinoembryonic antigen (CEA) Normal reference value: serum <5μg/L. Clinical significance: 1. Elevated serum CEA is mainly seen in colon cancer, rectal cancer, pancreatic cancer, gastric cancer, liver cancer, breast cancer, etc. Other malignant tumors also have different degrees of positive rates. 2, CEA continuous follow-up test, in general, the serum CEA concentration decreases when the disease improves and increases when the disease deteriorates. 3, intestinal diverticulitis, rectal polyps, colitis, cirrhosis, hepatitis and lung disease have different degrees of elevation, but the percentage of positivity is low. 4. 98% of non-smoking healthy people have serum <5μg/L and about 39% of smokers have CEA >5μg/L. 3. Prostate-specific antigen (PSA) Normal reference value: <40μg/L. Clinical significance: 1. After prostate cancer surgery, PSA can gradually decrease to normal. If PSA concentration does not decrease after surgery or increases again after decreasing, tumor metastasis or recurrence should be considered. 2.Serum PSA level can also be elevated in prostate hypertrophy, prostatitis, kidney and genitourinary system diseases, but it must be combined with other examinations for differentiation. 3. About 5% of prostate patients have elevated prostatic acid phosphatase (PAP), but PSA is at normal levels. IV. Glycoconjugate chain antigen 19-9 (CA19-9) Normal reference value: serum <37 U/ml. Clinical significance: 1. In pancreatic cancer, gallbladder cancer and bile duct pot belly cancer, serum CA19-9 level is significantly increased, especially in patients with advanced pancreatic cancer, serum CA19-9 concentration can reach 400,000 U/ml, with a positive rate of about 74.9%. The positive rate of gastric cancer is about 50%, colon cancer is about 60%, and liver cancer is about 64.6%. 3, acute pancreatitis, cholecystitis, cholestatic cholangitis, liver cirrhosis, hepatitis and other diseases CA19-9 also have different degrees of elevation. V. Sugar chain antigen 50 (CA50) Normal reference value: serum <24U/ml. Clinical significance: 1. Elevated serum CA50 in pancreatic cancer, colon cancer, rectal cancer, gastric cancer, etc., especially in patients with pancreatic cancer is most obvious. 2. Elevated CA50 can be seen in liver cancer, lung cancer, uterine cancer, ovarian cancer, kidney cancer, breast cancer, etc. CA50 is also elevated in ulcerative colitis, liver cirrhosis, melanoma, lymphoma, autoimmune diseases, etc. Cancer antigen 125 (CA125) Normal reference value: serum <35 U/ml. Clinical significance: 1. The serum CA125 level of ovarian cancer patients is significantly elevated, but the CA125 level decreases quickly if surgery and chemotherapy are effective. In case of recurrence, CA125 elevation may precede the clinical symptoms. 2.Other non-ovarian malignant tumors also have a certain positive rate, such as breast cancer 40%, pancreatic cancer 50%, gastric cancer 47%, lung cancer 44%, colorectal cancer 32%, and other gynecological tumors 43%. 3.Non-malignant tumors, such as endometriosis, pelvic inflammatory disease, ovarian cysts, pancreatitis, hepatitis, liver cirrhosis, etc. have different degrees of elevation, but the positivity rate is low. 4. Elevated CA125 is found in the thoracoabdominal fluid, and higher concentrations of CA125 can also be detected in amniotic fluid. 5. Elevated CA125 is also possible in the first 3 months of early pregnancy. VII. Cancer antigen 15-3 (CA15-3) Normal reference value: serum <28 U/ml. Clinical significance: 1. Patients with breast cancer often have elevated CA15-3, but the sensitivity is low in the early stage of breast cancer. Other malignant tumors, such as: lung cancer, colon cancer, pancreatic cancer, ovarian cancer, uterine cancer, primary liver cancer, etc., also have different degrees of positive rates. 2. Non-malignant neoplastic diseases such as liver, gastrointestinal tract, lung, breast, ovary, etc., generally have a positive rate of less than 10%. VIII. Squamous cell carcinoma antigen (SCC) Normal reference value: serum <5μg/L. Clinical significance: 1, cervical cancer, lung cancer, head and neck cancer, serum SCC is elevated, and its concentration increases with the aggravation of disease stage. 2, Hepatitis, cirrhosis, pneumonia, renal failure, tuberculosis and other diseases, SCC also has a certain degree of elevation. IX. Tissue polypeptide antigen (TPA) Normal reference value: serum <55 U/L. Clinical significance: 1. Elevated serum TPA is mainly seen in bladder cancer, prostate cancer, breast cancer, ovarian cancer and gastrointestinal malignant tumors, especially for the diagnosis of metastatic cells in the bladder with high sensitivity. Since the level of TPA is related to the proliferation and differentiation of tumor cells, if the level of TPA drops to normal, it indicates that the tumor treatment is effective. 2.Elevated TPA in serum can also be seen in acute hepatitis, pancreatitis, pneumonia and gastrointestinal diseases. 3. Elevated TPA can be seen in the last 3 months of pregnancy. X. Neuron-specific enolase (NSE) Normal reference value: serum <15 μg/L. Clinical significance: 1. Can be used to identify, diagnose, and monitor the therapeutic effect of small cell lung cancer after radiation and chemotherapy. The NSE concentration gradually decreases to normal level when the treatment is effective, and increases in case of recurrence. It is 4~12 weeks earlier than the clinical determination of recurrence to monitor recurrence by elevated NSE. 2.It can be used to monitor the change of neuroblastoma, evaluate the efficacy of treatment and forecast relapse. Serum NSE can also be increased in neuroendocrine cell tumors, such as pheochromocytoma, islet cell tumor, medullary thyroid carcinoma, melanoma, retinoblastoma, etc. XI. Growth hormone (HGH) Normal reference value: 7.5 μg/L. Clinical significance: 1. Pituitary adenoma, kidney, lung and other organ tumors can cause HGH levels to rise in the body. 2, HGH secretion increases in cases of starvation, malnutrition, hypoglycemia, stress, exercise, etc. 3, acromegaly, gigantism, etc. HGH is significantly elevated and can be used for diagnosis and efficacy observation. 4.The application of certain drugs such as estrogen, insulin, arginine, etc. can often increase HGH secretion. 5.Patients with chronic hepatitis and liver can develop hyper-HGHemia, which may be related to the increased secretion rate of HGH in the anterior pituitary gland and reduced degradation of HGH by hepatocytes. 6, pituitary dwarfism, hypopituitarism, obesity, etc., HGH secretion is reduced. Serum ferritin (SPE) Normal reference value: Male 23.9~336.2 ng/ml. Female 11.0~306.8 ng/ml. Clinical significance: 1. Significant for the adjuvant diagnosis of tumors. SF is significantly increased in various malignant tumors, such as leukemia, lymphoma, solid tumors of pancreas, lung or liver and breast cancer recurrence and metastasis. SF and AFP co-test can help in early detection of liver cancer: when AFP is low and SF is abnormally increased, be alert to the possibility of tumors. 2, various inflammatory infections, cirrhosis, hepatic necrosis and other liver diseases, early acute heart attack, repeated blood transfusion, etc., SF content will increase. 3.It is meaningful for the diagnosis of iron deficiency anemia: when SF is also a reliable indicator for the diagnosis of occult iron deficiency anemia. ④SF and CEA co-test can improve the positive rate of diagnosis of lung cancer. XIII. Human chorionic gonadotropin (hCG) Normal reference value: serum male <5 mlU/ml, non-pregnant women <7 mlU/ml, pregnant women female 6~8 weeks of pregnancy 530~180 000 mlU/ml; 9~12 weeks of pregnancy 10 000~320 000 mlU/ml; 6~9 months of pregnancy 1 000~190 000 mlU/ml. Clinical significance 1.It is a good indicator for diagnosing early pregnancy and monitoring preterm abortion and ectopic pregnancy. 2.In early chorionic epithelial cell carcinoma and chylothorax, hCG in blood is significantly higher than the level of early pregnancy. After chemotherapy or curettage treatment, if hCG decreases not obviously, it indicates poor treatment effect. After treatment, hCG decreases and later seen to increase again, suggesting recurrence. 3. Teratoma, testicular non-seminomatous cell tumor and embryonic tumor can be seen with elevated hCG. XIV. β2 microglobulin (β2M) Normal reference value: serum 24mg/L, urine <160μg/L. Clinical significance: 1. Malignant tumors: such as liver cancer, lung cancer, gastric cancer, colon cancer, rectal cancer, multiple myeloma, non-Hodgkin's lymphoma, chronic lymphocytic leukemia, etc., all have significantly elevated serum β2M, and urinary β2M can also be increased. It can be used as a monitoring indicator for the development of malignant tumor. 2, renal diseases: such as acute and chronic pyelonephritis, tubular inflammation, congenital tubular acidosis, tubular drug damage, tubular heavy metal toxic damage, etc., urinary β2M is elevated. 3, urinary β2M is elevated in renal transplant rejection. 4, immune diseases: such as systemic lupus erythematosus, dry syndrome, rheumatoid arthritis, AIDS, etc., β2M in the serum is elevated. Fifteen, pancreatic embryonic antigen (pancreatic-cofetalantigen, POA) Normal reference value: less than 7 ku/L in normal population serum as determined by RIA method. Clinical significance: pancreatic embryonic antigen is an antigen proposed by Banwo et al. from fetal pancreas in 1974 and was officially named by the International Society for Cancer Biology and Medicine in 1979. POA is a glycoprotein with a molecular weight of 40 ku and exists in serum as a complex with a molecular weight of 900 ku, but can be degraded to 40 ku. The positive rate of POA in pancreatic cancer is 95%, and its serum content is greater than 20 ku/L. POA is also elevated when malignant tumors such as liver, colorectal and gastric cancers are present, but the positive rate is lower. In summary, although various markers have their own clinical significance, a comprehensive analysis is needed to reach a correct diagnosis. Generally, CEA, NSE, TPA, SCC are checked for lung cancer; CEA, AFP for liver cancer; CEA, CA15-3, TPA for breast cancer; CEA, CA19-9 for stomach cancer; PSA, PAP (prostate acid phosphatase) for prostate cancer; CEA, CA19-9, CA50 for colorectal cancer; CEA, CA19-9, CA50 for pancreatic cancer; CA125 for ovarian cancer; AFP, Hcg for testicular tumors; SCC for cervical cancer; TPA for bladder cancer; β2M for myeloma. patients should never see a particular index mildly when there is no basis for pathological cytology diagnosis.