Currently, there is a rapid increase in cancer incidence. First of all, this concerns neoplasms in the gastrointestinal tract. Therefore, it is important to know which tests will help make this diagnosis. After all, cancer is not a death sentence. With the timely appointment of therapy, a stable remission can be achieved.
One of the effective methods for diagnosing tumors is the analysis of gastrointestinal tumor markers.
The essence of the survey
Gastrointestinal tumor markers are large molecules composed of lipids, carbohydrates and proteins. They can be synthesized both directly by organs that have undergone cancerous degeneration, and by he althy tissues of the body. In the second case, the production of these substances is a response to cancer aggression.
Most of the oncomarkers belong to the organ-specific group. That is, the detection of a specific substance in the blood indicatesdamage to a specific organ.
But it would be fair to say that an increase in the number of tumor markers does not necessarily indicate the development of a cancerous process. Therefore, it is very important to conduct repeated examinations and monitor changes in indicators over time.
Indications for examination
Assignment of analysis for oncomarkers of the gastrointestinal tract to everyone is not correct. After all, as already mentioned, in he althy people their level can be increased. Examination without reasonable reasons can lead to an incorrect diagnosis, which will undermine the psychological he alth of a person.
Consequently, before answering the question of which tumor markers should be taken for diseases of the gastrointestinal tract, it is necessary to explain the indications for this examination method:
- precancerous pathological processes in the intestines, stomach, pancreas and liver;
- the doctor has serious suspicions of gastrointestinal cancer;
- after surgery to check if the tumor tissue has been completely removed;
- when conducting anticancer chemotherapy to evaluate its effectiveness;
- to diagnose cancer metastasis or recurrence before symptoms develop;
- to predict the further development of the tumor process.
Thus, the appointment of gastrointestinal tumor markers in cancer is necessary for both diagnostic and prognostic purposes.
Preparing for and conducting the analysis
Becausedetermination of the level of tumor markers is carried out in the blood, then the preparation for this analysis is practically no different from that in other blood tests. In order for the analysis to have the greatest diagnostic value, you must adhere to the following rules:
- blood is donated in the morning before meals;
- refuse to eat at least 8 hours before the examination;
- at least a day before the analysis, do not eat heavy food: fatty, fried, smoked;
- immediately before the analysis, it is allowed to drink ordinary, non-carbonated water.
Venous blood is taken to diagnose tumors. To do this, the nurse pre-treats the injection site with cotton swabs with an antiseptic. After that, she takes a sterile disposable syringe and gently draws blood from a vein. A label with the patient's data is glued to the blood bottle, and the blood is sent to the laboratory for further counting of the number of tumor markers.
The result is given to the patient the very next day. In this case, the norm is indicated according to the data of a particular laboratory, and next to it is the level of the substance found in the patient's blood.
The final interpretation of the result and the diagnosis is made by the attending physician. He evaluates the analysis data for window markers, the results of instrumental methods of examination and the clinical manifestations of the disease in a complex manner. Only with this approach to diagnosis can a correct diagnosis be made.
Types of digestive tract tumor markers
Which oncomarkers of the gastrointestinal tract to take in the presence of the abovetestimony? The following types of them have the greatest diagnostic value:
- CA 242;
- CA 125;
- SA 19-9;
- SA 72-4;
- SA 15-3;
- hCG - human chorionic gonadotropin;
- AFP - alpha-fetoprotein;
- CEA - cancer embryonic antigen.
Chorionic gonadotropin and alpha-fetoprotein are substances that can normally be present in humans. They are signs of pregnancy. Small amounts are acceptable in non-pregnant women and men. But their high numbers and rapid growth indicate the development of the tumor process.
CA 242 and CA 19-9
When answering the question of which gastrointestinal tumor markers are the most informative for making a diagnosis, it is worth noting CA 242 and CA 19-9. Usually these two substances are defined in a complex way.
The concentration of CA 242 is increased in the blood in malignant tumors of the pancreas and intestines. Its detection at a tumor of a rectum is especially characteristic. But the level of the tumor marker can also increase with inflammatory processes in the stomach and intestines, as well as with the growth of benign tumors. Therefore, when making a cancer diagnosis, this oncological marker is not determined in isolation, but together with CA 19-9.
The production of CA 19-9 occurs in the epithelial cells of the respiratory tract and gastrointestinal tract. Its level in the blood increases with cancer of the rectum, stomach and gallbladder. A slight increase in its amount is also possible with other, non-oncological processes:
- cirrhosis of the liver;
- cholecystitis;
- hepatitis;
- gallstone disease;
- pancreatitis.
The development of cancer is evidenced by a sharp and significant increase in the level of gastrointestinal tumor markers, as well as their progressive increase in dynamics.
CA 125, CA 72-4 and CA 15-3
CA 125 is synthesized by the epithelium of the digestive canal and respiratory tract in the fetus, and in adults only in the respiratory system. Its sharp increase is most characteristic of pancreatic cancer. It is also determined in malignant neoplasms of the liver, distal colon, and stomach. Its slight increase is observed during pregnancy, severe liver disease, inflammation of the pancreas and the inner layer of the uterus.
Determination of the level of the oncomarker of the gastrointestinal tract CA 72-4 is carried out in the diagnosis of carcinoma of the pancreas and intestinal tube. It is produced by the epithelial cells of the alimentary canal. The development of a malignant process is indicated by an increase in CA 72-4 along with CA 19-9, CA 125 and CEA. An isolated increase in CA 72-4 is possible in these non-cancerous conditions:
- benign breast tumor;
- benign ovarian tumors;
- benign neoplasms of the lungs and liver;
- during pregnancy.
Cancer marker CA 15-3 is considered specific for the diagnosis of breast cancer. But its increase, along with other oncomarkers of the gastrointestinal tract, indicates the development of stomach cancer orintestines. A minimal increase in the concentration of CA 15-3 is possible during pregnancy, rheumatism, HIV infection, impaired liver and kidney function.
hCG, AFP and CEA
Chorionic gonadotropin is a hormone produced by a small formation in the brain called the pituitary gland. The presence of this hormone is necessary for the normal course of pregnancy. A sharp increase in this substance in the blood of men or non-pregnant women is observed with carcinoma of the liver, stomach or intestines. In some women, levels rise sharply at menopause.
Alpha-fetoprotein is a substance that is synthesized in the fetus by the yolk sac, and in adults and children is produced by liver cells. An increase in the amount of alpha-vetoprotein in the blood, along with an increased concentration of other gastrointestinal tumor markers, indicates pancreatic cancer or liver carcinoma.
Cancer Embryonic Antigen
The synthesis of cancer-embryonic antigen should be completely absent after the birth of a child. Its remains are found in the epithelial cells of the stomach and intestines, respiratory tract. Its concentration increases with malignant neoplasms of the stomach and rectum.
A slight increase in its level is possible with autoimmune diseases of the connective tissue (rheumatism, systemic lupus erythematosus), the presence of cysts in the ovaries and mammary glands, infectious lesions of the respiratory system. Its level is also slightly increased in smokers.
Transcription of analysis
Normaoncological markers in the blood may differ depending on the laboratory in which the analysis was taken. For example, in some laboratories, the norm of the gastrointestinal tumor marker CA 242 is up to 30 IU / ml, in others - up to 20 IU / ml. Average normal values are shown in the table below:
| CA 242 | up to 20 IU/ml |
| SA 19-9 | 40 IU/ml |
| CA 125 | 7 IU/mL |
| CA 72-4 | 20 - 30 IU/ml |
| SA 15-3 | 20 - 30 IU/ml |
| hcg | up to 10 IU/ml |
| AFP | 5 - 10 IU/ml |
| REA | 8 ng/ml |
Treatment methods
If during the test an elevated level of gastrointestinal tumor markers in the blood is detected, the doctor prescribes additional instrumental examinations: ultrasound, CT, scintigraphy. After the final diagnosis is made, the oncologist determines the tactics of treatment. Therapy of malignant neoplasms of the gastrointestinal tract depends on the prevalence and neglect of the process, the specific localization and type of tumor.
The following methods of treatment of cancer of the digestive system are used:
- surgical treatment - resection of the affected part of the intestine or stomach, complete removal of the organ, liver transplantation;
- chemotherapy;
- radiotherapy;
- hormone therapy;
- targeted therapy.
In the last stages of cancer, palliative care is used. It is not able to completely cure the patient, butrelieves symptoms and improves quality of life.
