Tumor markers: what they show, where to donate blood for tumor markers for free

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— Oncology — Checking blood for tumor markers
Oncological diseases take second place after cardiovascular pathologies among the causes of death of patients in Russia. Negative statistics are associated with late detection of pathology. According to experts, with the help of early diagnosis, the survival rate of cancer patients can be doubled. There are plenty of methods for this.

Among the most common methods of early diagnosis of cancer is a blood test for specific chemical compounds - tumor markers. Based on its results, it is impossible to accurately determine whether a person has cancer or not. The diagnostic value of the study is the ability to suspect the initial stage of the disease by continuing the study using clinical methods.

What are tumor markers

Tumor markers are specific biomolecules produced by pathologically altered cancer cells. More often they are protein compounds, but can have a different nature: enzymatic, hormonal or receptor. Most of these markers are also synthesized by healthy cells of the body, but in much smaller quantities.

The term “tumor marker” was first introduced in the 60s of the last century by domestic scientists Harry Abelev and Lev Zilber. While conducting research, they discovered that an increase in the AFP protein produced by the placenta during pregnancy is characteristic of malignant liver tumors. This marker was the first to be included in clinical practice in tumor research.

Today, more than two hundred types of specific compounds have been identified, but only about twenty are subject to analysis.

Markers are found in various biofluids at the initial stages of the formation of malignant cells, in the preclinical (asymptomatic) stage of tumor formation. Connections are divided into two types. Markers of high specificity are highly likely to identify a specific disease, while markers of low specificity are characteristic of a number of different pathologies.

Based on the probable location of the tumor, experts identify tumor markers:

• mammary gland;
• testes;
• Bladder;
• pancreas;
• liver;
• esophagus;
• stomach;
• thyroid gland;
• lungs;
• skin;
• prostate gland;
• ovaries;
• uterus;
• intestines.

Doctors are ambivalent about this classification. This is due to the fact that no ideal marker has been identified to date. None of them has 100% specificity, allowing one to unambiguously identify cancer of a specific organ.

AFP

AFP is a glycoprotein. Normally, it is secreted by the cells of the liver and gastrointestinal tract of the fetus, so it is used for screening studies during pregnancy to identify pathologies of intrauterine development. But in oncology, this marker is determined for hepatocellular carcinoma (liver cancer) and malignant neoplasms of the gonads. A moderate increase in AFP levels can be observed in liver pathologies - chronic hepatitis, cirrhosis, as well as in severe intoxication. The material for research is blood.

Why do blood tests for tumor markers?

Analysis for tumor markers is often used as an evaluative test to determine positive (or negative) dynamics in cancer therapy. Based on its results, relapse can be prevented.

Markers allow you to:

• confirm or refute the assumptions of preliminary diagnostics;
• notice the formation of metastases in the absence of other symptoms;
• evaluate the effectiveness of the prescribed therapeutic course.

The study is not recommended as an independent diagnosis due to the large number of false positive (false negative) results. But, in combination with other methods, it helps to identify cancer at an early stage.

What does deviation from the norm indicate?

In oncology, the stage of the disease is diagnosed based on the number of specific proteins, and the probable location of the tumor is determined based on their type.

In addition to cancer, compounds are detected in the presence of cysts, infections, inflammatory processes, and other benign pathologies in the body.

Attention: tumor markers are present in small amounts in the blood of healthy people.

We will provide data on the normal content of such substances in the body and the expected problems if deviations from it are detected.

Separately, the AFP marker should be noted. In gynecology, it is used to assess the state of pregnancy. In oncology, it signals the possible development of cancer of the liver, ovaries, breast, bronchi and lungs, and gastrointestinal tract.

For pregnant women, the AFP norm by week is as follows:

• up to 12 - less than 15 U/ml;
• 13-15 - from 15 to 60 U/ml;
• 15-19 - from 15 to 95 U/ml;
• 20-24 - from 27 to 125 U/ml;
• 25-27 - from 52 to 140 U/ml;
• 28-30 - from 67 to 150 U/ml;
• 31-32 - from 100 to 250 U/ml.

Attention: exceeding these indicators may indicate pathologies in the development of the fetus.

In addition, elevated AFP is a sign of hepatitis or cirrhosis.

Based on the data presented in the table, we can conclude that deviations in the indicators of one or another tumor marker indicate the likelihood of developing a number of different diseases. It is not possible to make a diagnosis based only on the content of specific proteins in the blood. To confirm (or deny) the presence of a cancerous tumor in the body, additional diagnostic procedures will be required.

Screening examination programs

Screening programs use several tumor markers to screen patients at risk. These are tumor markers:

• HCG is human chorionic gonadotropin. Often assessed in conjunction with AFP (see below) to estimate the likelihood of ovarian cancer in women and testicular cancer in men.
• PSA - Prostate specific antigen, is recommended for all men over 40 years of age for an annual examination to diagnose prostate cancer.
• AFP – alpha fetoprotein. It is used to detect liver cancer, and in pregnant women - to assess developmental disorders in the fetus and chromosomal pathologies.
• Ca-125 is the main marker of ovarian cancer and its metastases, as well as tumors of the uterus, mammary glands, stomach, pancreas and liver. It is not used as an independent method and is only an indication for a more in-depth examination.

Degree of reliability of markers in oncology

Analysis of the content of these substances is very informative for assessing the prescribed therapeutic course for cancer. In primary diagnosis, none of them is used independently. This is due to the lack of specificity of the markers.

The reliability of the readings of specific proteins can be considered using the example of the most common of them. These include the PSA test. This tumor marker should be tested in men for timely detection of prostate cancer. In case of malignant tumors of the gland, this indicator actually exceeds the norm. But it also increases if a benign neoplasm forms in the prostate. As medical practice shows, prostate cancer was not confirmed in most men with elevated PSA levels.

Attention: there are cases when unscrupulous doctors in dubious clinics prescribe unnecessary therapeutic procedures. They not only require serious financial investments, but can also provoke serious complications!

Another indicative marker is CA-125. It grows in the blood of women who have ovarian cancer, but can increase in a large number of other pathologies not related to oncology.

Medicine knows of cases when, in the late stages of the formation of malignant neoplasms in the ovaries, a blood test did not show deviations in the results of any of the 28 protein compounds specific to this disease.

CA-125 is not recommended for testing in the initial stages of the disease in the absence of characteristic symptoms. To analyze the course of the diagnosed pathology, it is considered together with other proteins, as well as ultrasound results.

As part of a comprehensive examination, women with poor heredity or gene mutations need to take tumor markers every six months.

In general, the question of how much one can trust tumor markers remains open today. When interpreting research results, you should pay attention to a number of factors that can distort the data:

• the level of protein content is affected by inflammatory diseases in acute or chronic form;
• CA-125 increases during menstruation;
• smokers are characterized by a twofold increase in the CEA index;
• A normal test result does not guarantee the absence of a tumor.

These are the most common nuances, but there may be other “subtleties”. Only a qualified doctor who can correctly decipher the results can understand them.

REA

CEA is also a glycoprotein and is also normally secreted by the cells of the fetal digestive system. But after birth, its level drops sharply. It continues to be secreted by cells of the intestines, liver and pancreas, but in very low quantities. An increase in CEA levels is observed in a number of inflammatory diseases, autoimmune pathologies and benign neoplasms. Its sharp increase is also noted in malignant tumors of the large intestine and some other localizations. Since this tumor marker is not specific, its determination is rather of an auxiliary nature and is carried out to assess the effectiveness of treatment, monitor relapses or progression of pathology in patients with an initially high level of CEA. The material for the study is venous blood.

Indications for tumor marker analysis

During the period of active growth, cancer tissue absorbs nutrients and releases breakdown products, many of which are toxic. These processes affect human health, causing characteristic symptoms.

Any history taking begins with interviewing the patient. Doctors may be alert to the following changes in your health:

• a sharp decrease in body weight for no apparent reason;
• increased fatigue;
• refusal of food;
• constant or recurrent pain;
• frequent weakness;
• low-grade body temperature (from 37.1 to 38.0 °C for a long time).

Oncological pathology is also reflected in the results of standard blood tests. A general analysis can reveal an increase in ESR, a decrease in leukocytes or hemoglobin. Negative changes are also noted in the “biochemistry” of the blood.

Malignant neoplasms are characterized by a decrease in protein content, acceleration of blood clotting, and an increase in ESR.

Such research results in themselves do not indicate the growth of pathologically altered cells, but are a reason for additional examination. Including testing for tumor markers.

Exceptions are people from risk groups who are recommended to undergo this procedure regularly.

These include patients:

• with a hereditary predisposition (if cancer was diagnosed in relatives up to the second generation);
• upon returning from places of man-made disasters;
• survivors of significant intoxication;
• in the presence of benign tumors;
• living in settlements with poor ecology.

For men over 50 years of age, it is advisable to do a PSA test annually to timely detect changes in the activity of the prostate gland. The analysis is also indicated for those who have already been diagnosed with cancer. Studies are prescribed not only to patients undergoing treatment, but also to those who have been successfully cured. This allows you to stop possible relapses of the disease. Preliminary preparation of a person for analysis increases the likelihood of obtaining an accurate result.

Stool analysis

Blood may also be present in the stool, and it is almost impossible to notice it visually. Laboratory analysis will help determine its presence.

The presence of blood in the stool is a sign of intestinal cancer (most often colon), but it is also a symptom of many benign gastrointestinal diseases. Polyps in the intestines can bleed. Moreover, it should be remembered that polyps tend to degenerate into a malignant tumor. In any case, the presence of blood in the stool is a reason to undergo a more in-depth diagnosis and take tests to detect cancer.

Feces are also collected in a sterile container in the morning.

How to donate blood for tumor markers

The attending physician should give specific recommendations on restrictions before blood collection. They depend on which specific protein will be studied.

The general rules are as follows:

• donate blood at least 8 hours after your last meal;
• try not to be nervous during the procedure;
• interrupt serious training for a week;
• stop drinking alcohol three days before;
• It is advisable not to smoke immediately before collecting biomaterial;
• If in the next week the patient underwent x-rays or other examinations, the doctor must be informed about this.

Other requirements may need to be met. Thus, if you suspect a prostate tumor, it is advisable to abstain from sexual intercourse for 7 days; it is better not to test blood for tumor markers of the female reproductive system during menstruation.

Where can I get tested for tumor markers?

You can get tested for tumor markers free of charge (with compulsory medical insurance and a referral from a therapist or oncologist) at the clinic. The result is usually ready within a day. However, not all medical institutions have the necessary equipment.

You can undergo examination in diagnostic centers or private clinics, but you should not decide on your own whether it is necessary. You should donate blood only as prescribed by your doctor. The specialist will give an adequate assessment of the patient’s condition and select the most specific compounds for a particular case. Research on all groups of tumor markers is meaningless. Plus it's not cheap. Prices range from 300 to 2000 rubles for each substance, depending on the region and clinic.

Tumor markers are effective indicators of tracking tumor response to patient therapy. As a method of initial detection of oncological pathologies, they do not guarantee an accurate result. By analyzing specific proteins, one can suspect the presence of cancer cells and other dangerous diseases. An oncologist should decipher the received data. Self-diagnosis often leads to erroneous conclusions, incorrect treatment and serious health consequences.

Advantages and disadvantages of tumor markers

First, let's list the advantages of the method:

• ease of research;
• possibility of use for screening;
• possibility of diagnosis at the precancer stage;

Testing for tumor markers allows you to:

• identify groups at high risk of developing cancer;
• limit the area of ​​oncological search for subsequent in-depth examination;
• monitor the dynamics of the tumor process;
• monitor the early occurrence of relapse (although many experts note that tumor relapse and the increase in tumor markers do not occur simultaneously);
• assess the success of surgical treatment: whether the entire tumor has been removed;
• monitor the tumor’s response to therapy instead of various laboratory and instrumental examination methods. It is not only the decrease in tumor marker numbers that matters, but also its increase. The latter may indicate the success of chemotherapy in the case of rapid massive death of tumor cells and the release of their decay products into the bloodstream.

Important: testing for tumor markers makes it possible to detect cancer 1-6 months earlier than other examination methods.