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

Certain types of cancer lead to characteristic changes throughout the body, including at the molecular level. Such changes can be detected using relatively simple laboratory tests for tumor markers. With certain malignant tumors, an increase in one or another indicator is observed. In particular, carbohydrate antigen 125 (or CA-125) makes it possible to suspect ovarian cancer and some other oncological pathology, as well as monitor the patient’s condition after treatment has already been carried out.

Detailed description of the study

CA 125 is a protein that is found on tumor cells of the ovarian epithelium and normally in cells of the endometrium, peritoneum, pleura, pericardium and testicles. It enters the bloodstream, for example, during menstruation, endometriosis, and in the first trimester of pregnancy. The presence of CA 125 does not always indicate an oncological process - small amounts of the protein are produced by various tissues of the body, as well as malignant tumors of other etiologies (endometrium, gastrointestinal tract, fallopian tubes, lungs and gastrointestinal tract). Increased levels of CA 125 in the blood may be associated with pelvic inflammation.

A test for the CA 125 antigen allows you to detect malignant neoplasms of the ovaries or mammary gland at the earliest stage, when changes in the body are minimal and the chances of recovery are highest. It also helps to detect metastases before the onset of clinical manifestations.

Indications

Most often, a referral to test CA-125 levels is given by an oncologist or gynecologist.

An antigen test is recommended in the following cases:

• for suspected ovarian cancer
• assessment of the risk of recurrence or metastasis of serous ovarian cancer after therapy;
• control of endometriosis treatment;
• an additional marker in the diagnosis of adenocarcinoma of the pancreas, gastrointestinal tract and others (bronchi, kidneys, testes, mammary glands, etc.).

Most often, CA-125 is used to monitor the recurrence of an ovarian tumor: an increase in the level of CA-125 (even in the absence of clinical and radiological evidence of relapse) indicates a biochemical relapse of the tumor, which is ahead of the clinical one by 2-6 months.

In clinical studies, CA-125 has proven to be a reliable marker for monitoring patients with B-cell non-Hodgkin lymphoma.

References

1. TUMOR MARKERS IN BREAST CANCER V.F. Semiglazov, corresponding member of the Russian Academy of Medical Sciences, Doctor of Medical Sciences, Professor V.V. Semiglazov, Doctor of Medical Sciences, Professor G. Dashyan, Candidate of Medical Sciences A. Bessonov, R. Paltuev, Candidate of Medical Sciences, T. Semiglazova, Candidate of Medical Sciences, I. Grechukhina, K. Penkov, A. Vasiliev, A. Manikhas - Candidate of Medical Sciences, Research Institute of Oncology named after. N.N.Petrova, St. Petersburg State Medical University named after. acad. I.P. Pavlova, City Clinical Oncology Dispensary St. Petersburg.
2. Baselga J., Tripathy D., Mendelsohn J. et al. Phase II study of weekly intravenous recombinant humanized anti-p185HER2 monoclonal antibody in patients with HER2/neu-overexpressing metastatic breast cancer // J. Clin. Oncol. – 1996; 14: 737–744.
3. CobleighM., Vogel C., Tripathy D. et al. Multinational study of the efficacy and safety of humanized anti-HER2 monoclonal antibody in women who have HER2 -overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease // J. Clin. Oncol. – 1999; 17:2639–2648

SA-125 is normal

Important! Standards may vary depending on the reagents and equipment used in each particular laboratory. That is why, when interpreting the results, it is necessary to use the standards adopted in the laboratory where the analysis was carried out. You also need to pay attention to the units of measurement. Normal tumor marker values

Factors of influence

Distort the result of the study, i.e. The following reasons may show a false positive result:

• intensive drug therapy;
• pregnancy;
• menstruation and cycle disorders;
• chronic stress;
• violation of the rules for taking a test or drawing blood.

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.

Increase SA-125

Important! The interpretation of the results is always carried out comprehensively. It is impossible to make an accurate diagnosis based on only one analysis.

Increase to 45 U/ml

A slight increase in CA-125 occurs in diseases involving the serous membranes:

• pleurisy;
• peritonitis;
• pericarditis.

Increase to 65 U/ml

In the presence of a benign ovarian neoplasm, the rate can normally increase to 60 U/ml, which is associated with the destruction of epithelial tissue. In this case, the level of CA 125 should be regularly monitored (in order to assess the risk of tumor malignancy), especially in women in menopause.

• benign gynecological tumors (for example, fibroids);
• inflammatory processes involving the appendages (adnexitis);
• endometriosis.

Increase to 100 U/ml

An increase in CA-125 to 100 U/ml or higher indicates the risk of developing a malignant process and the need for additional research, including a test for the HE4 tumor marker.

• Ovarian carcinoma;
• Adenocarcinoma of the cervix;
• Endometrial cancer;
• Cancer of other internal organs, including in males.

The level of CA 125 can correlate with the level of natriuretic hormone, so the severity of heart failure is determined based on the test results.

3.What are the risks and what may affect the analysis?

What are the risks of the CA-125 blood test?

Possible risks of the cancer antigen test may only be associated with the blood draw itself. In particular, the appearance of bruises at the puncture site and inflammation of the vein (phlebitis). Warm compresses several times a day will relieve phlebitis. If you are taking blood thinning medications, you may bleed at the puncture site.

What could affect the analysis?

CA-125 cancer antigen levels may change due to:

• Taking anticancer drugs;
• Recent examination using radiation;
• Previous abdominal surgery. The CA-125 test is done only 3 weeks after surgery.

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When is a CA-125 test prescribed?

Analysis is mandatory for the following categories of women:

• living in areas with unfavorable environmental conditions;
• working in industrial enterprises with harmful emissions;
• leading a promiscuous sex life;
• having already confirmed a diagnosis of the formation of tumors or cysts in the ovaries;
• those who gave birth to their first child after 35 years of age;
• having immediate family members who have been diagnosed with ovarian cancer;
• previously exposed to radiation or hormonal therapy;
• who have undergone treatment for oncological formations in the reproductive organs.

The study may be required at the stage of treatment for ovarian cancer to monitor the success of the therapy used. It is also carried out to detect recurrence of ovarian cancer. CA-125 can be repeated: before and after treatment. This helps doctors obtain reliable data on the success of the fight against pathology. In some cases, women are referred for testing during treatment if there are factors that could skew the results.

Important!

If a patient has more than one reason for testing for CA-125, then she is prescribed additional procedures. For example, an analysis is carried out for the HE-4 tumor marker.

Ovarian cyst or pregnancy

Most often, women confuse pregnancy with a follicular cyst or corpus luteum cyst. The signs of such cysts are very similar to the early symptoms of pregnancy. The hCG level increases with an ovarian cyst, as with pregnancy, so at the first sign you should consult a gynecologist.

The Oncology Clinic of the Yusupov Hospital offers a wide range of surgical interventions in the field of gynecology. Our gynecological oncologists are true professionals in their field, using in their practice only the latest treatment protocols that meet international standards.

Thanks to the qualified specialists of the Yusupov Hospital and modern European equipment, you will receive high-quality specialized advice. The medical staff guarantees an individual approach to each patient, as well as comfortable conditions of stay in the hospital. The clinic’s doctors will be happy to provide you with detailed information about ovarian cysts, treatment features, diagnostic ultrasound, as well as prices for services. You can make an appointment and consultation by phone.

What does an ovarian cyst look like on an ultrasound?

An ultrasound examination of a functional (anechoic) ovarian cyst has thin, smooth walls, without internal inclusions, acoustic enhancement behind the formation, and is more than 30 mm in size. Such neoplasms are most often single-chamber, round or oval in shape, the boundaries are clear and even, and healthy ovarian tissue can be seen along the periphery.

Ultrasound of an ovarian cyst: on what day of the cycle should it be done? Ultrasound examination is best done from 2 to 5 days after the end of menstruation. On other days, visibility may be poorer and the structure of the ovary may be altered.

What to do after detecting a functional ovarian cyst on ultrasound?

• Functional cysts up to 3 cm at a young age are the norm → do not require treatment or observation;
• Cysts up to 7 cm in the reproductive period → ultrasound monitoring after the end of menstruation;
• Neoplasms up to 7 cm in postmenopause are almost always benign → Ultrasound observation;
• Ovarian cysts larger than 7 cm are difficult to evaluate using ultrasound → MRI is recommended.

A corpus luteum cyst on ultrasound has characteristic signs - a dense wall and a “ring of fire” with color Doppler mapping, up to 5 cm in size.

On ultrasound, hemorrhagic ovarian cysts look like single-chamber formations with hyperechoic inclusions. There is always no blood flow in the lumen of the cyst. Sometimes levels and an openwork mesh of fibrin threads are visualized. A hemorrhagic cyst has a thick wall and can resemble a huge tumor.

Tactics for patients with hemorrhagic ovarian cysts:

• Cysts less than 5 cm at a young age → do not require control;
• Formations larger than 5 cm in the reproductive period → Ultrasound control after menstruation;
• Hemorrhagic neoplasms in menopause → MRI of ovarian cysts is recommended.

A paraovarian cyst is an anechoic thin-walled neoplasm that is enclosed between the layers of the broad ligament of the uterus. Usually has a size of less than 5 cm. To distinguish a paraovarian cyst from a follicular one, it is necessary to separate the cyst from the ovary with a sensor.

An endometrioid ovarian cyst on ultrasound is a round hypoechoic formation with a double contour, having a wall 2-8 mm thick. There is no blood flow and dense inclusions in the lumen.

Dermoid cyst on ultrasound - an acoustic shadow is detected, indicating the presence of bone density elements.

Ovarian cystadenoma is a multi-chamber formation with tuberous edges, the contents are hypo- and anechoic, the walls are thickened.

Signs of a malignant ovarian cyst on ultrasound:

• Diameter more than 7 cm;
• Thick and lumpy cyst walls, with a developed vascular network;
• Intracystic septa larger than 3 mm, with abundant blood flow;
• Inside the cyst, huge formations with blood flow are determined;
• Ascites, lymphadenopathy and metastases.

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.

MRI of ovarian cyst

On MRI, Graafian follicles appear as hyperintense formations with thin walls, which are surrounded by ovarian stroma, which gives a not very intense signal.

Hemorrhagic cysts are characterized by high signal intensity; a component with high signal characteristics (fat, blood, etc.) is visualized. With fat suppression, the signal intensity does not decrease, which confirms the presence of hemorrhagic fluid.

The contents of an endometrioid cyst on MRI are manifested by increased signal intensity. Remains hyperintense, unlike teratomas.

Ovarian dermoid cyst is a cystic formation with hyperintense signal containing septa. In fat-suppressing mode, a decrease in signal intensity is determined.

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.