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实验室测试

Laboratory tests

哪些实验室测试用于诊断癌症?

This page was reviewed under our医学和社论政策by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 29, 2022.

如果怀疑癌症,医生可能会使用各种实验室检查。在进行癌症的实验室测试时,检查了血液,尿液,其他体液或组织的样本中的异常细胞或组织tumor markersthat may determine whether a person has the disease or a precancerous condition. Lab tests also may be used to screen high-risk patients, pinpoint the stage of cancer, identify treatment options and evaluate whether the cancer is responding to treatment. Lab tests may also be used to determine whether a patient has a癌症复发—a disease that has returned to its original location—or whether a new cancer has developed.

用于诊断和监测癌症的实验室测试类型的示例包括以下。

血液检查

血液检查在诊断和治疗癌症中起重要作用。血液检查不仅有助于确定您的整体健康,包括肾脏和肝功能, but the presence of certain chemicals and proteins in the blood can also help your doctor diagnose cancer. While blood tests alone cannot be used to diagnose cancer, when used with additional cancer diagnostic testing such as imaging, they help to guide diagnosis as well as help determine appropriate treatment options.

Circulating tumor cell (CTC) test

Cellsearch™ circulating tumor cell (CTC) tests may be used to monitor转移性乳房,colorectalandprostate cancers. This diagnostic test helps capture, identify and count circulating tumor cells in a blood sample. CTCs are cancer cells that detach from solid tumors and enter the bloodstream. This cancer blood test may be performed prior to the start of therapy or during the course of treatment.

完整的血数(CBC)测试

还有全血细胞计数(CBC)测试措施全国矿工工会ber of blood cells circulating in the bloodstream. Specifically, this cancer blood test measures a blood sample for the level of red blood cells, which carry oxygen throughout the body; white blood cells, which fight infection; and platelets, which help with blood clotting. The test also measures hemoglobin, a protein in red blood cells that carries oxygen, and hematocrit, the ratio of red blood cells to plasma.

A CBC may be used to detect a variety of conditions, includingleukemia, anemia and infection. Also, because somecancer treatmentsmay temporarily lower blood counts, oncologists often use CBC tests throughout treatment to closely monitor a patient’s blood counts.

组织测试

流式细胞仪

This test is used to diagnose and classify certain cancers, such as leukemia and lymphoma, and to evaluate the risk of recurrence. Flow cytometry also may be used as part of the stem cell transplantation process.

流式细胞仪measures the properties of cells in a sample of bone marrow, lymph nodes or blood. The sample is first treated with special antibodies and passed in front of a laser beam. If the antibodies attach to the cells, the cells give off light. The presence of certain substances, or antigens, on the surface of cells may help identify the cell type.

流式细胞仪may also be used to measure the amount of DNA in cancer cells. In this case, the cells are treated with special light-sensitive dyes that react with DNA. For patients with breast, prostate orbladder cancer,异常的DNA可能表明recurrence.

哺乳动物 +蓝图®test

哺乳动物®70-乳腺癌复发测定法可用于确定患者癌症恢复的风险。高风险得分意味着癌症有三合一的返回机会。低风险的结果使机会的机会达到10。任何结果都没有保证恶性肿瘤会或不会回来,但是评估可以用于指导治疗决策。

The Blueprint®80-Gene Molecular Subtyping Assay examines which of the tumor’s mutations are dictating the cancer’s behavior. When used with the Mammaprint assay, Blueprint may narrowly define each tumor into a subtype classification, which also may help guide treatment decisions.

Oncotype DX®test

TheOncotype DX实验室测试用于确定化学疗法是否可能受益于早期患者乳腺癌. It also helps evaluate the likelihood of disease recurrence.

This诊断测试is often performed on a small amount of tissue removed during breast cancer surgery and then examined at a molecular level. The Oncotype DX test provides specific information about the disease, which may help guide treatment decisions.

MammaPrint + BluePrint®vs. Oncotype DX®

In most cases, gene expression tests are used for early-stage cancers. The type of test your doctor recommends depends on your specific situation.

  • With some breast cancers, hormone receptor proteins are present; these are proteins that can stimulate cancer growth. Your doctor will test cancer cells from abiopsyfor estrogen receptors (ER) and progesterone receptors (PR). If testing indicates the presence of one or both of these receptors, the cancer is considered hormone receptor-positive. This information is useful in pinpointing a course of treatment. Hormone receptor-positive tumors may benefit from the use of hormone therapy drugs that block estrogen receptors. However, this treatment isn’t useful in treating cancers that are hormone receptor-negative (no estrogen or progesterone receptors).
  • HER2测试也是确定治疗选择的重要组成部分。HER2阳性肿瘤可能会对靶向HER2的癌症药物反应,HER2是乳腺细胞外部的蛋白质,使其导致它们转移faster. HER2-negative cancers don’t produce much of the protein HER2. Tumors that are hormone receptor-negative as well as HER2-negative are categorized astriple-negative breast cancer. These cancers are faster-growing than other types of breast cancer. HER2-negative and triple-negative cancers usually don’t respond to drugs targeting HER2.

Both your hormone receptor status and the results of your HER2 testing help determine what type of gene expression test is recommended for you.

The Oncotype DX test may be used if:

  • You have stage 1, 2 or 3A hormone receptor-positive tumors that are also HER2-negative, and that have spread to fewer than threelymph nodes.
  • 您的乳腺癌是0期(原位导管癌)。

The results of the Oncotype DX test may help determine whether you would benefit from化学疗法.

无论您的激素受体和HER2状态如何,都可以进行哺乳动物测试,以确定您的癌症会恢复的可能性。通常,如果您患有侵入性的乳腺癌,该乳腺癌的尺寸约为2英寸或更小,并且最多已扩散到三个淋巴结。

尿液分析

尿液分析或尿液检查可能有助于检测癌症。这种类型的诊断测试测量了尿液的成分,包括:

  • Sugars
  • Proteins
  • Red and white blood cells

它可以帮助检测某些癌症的存在。在尿液样品中发现的细胞的测试称为尿液细胞学。膀胱癌是这种方式发现的最明显类型的癌症,但是kidney, prostate andcervical cancer也可以通过尿液分析检测到细胞。

Additionally, urinalysis is done ifmultiple myeloma怀疑是在尿液中寻找骨髓瘤蛋白。如果检测到该蛋白质,则可能会进行额外的尿液测试,称为尿液蛋白电泳(UPEP)和尿液免疫固定。

Tumor marker tests

什么是肿瘤标记?

Tumor markersare substances in the body that are produced in much higher quantities when cancer or certain benign conditions are present. The substances may be found in the blood, urine, stool or tumor tissue. Most of these substances are proteins, but sometimes gene expression patterns and DNA changes are used as tumor markers, as well.

由于肿瘤标记升高不一定表明癌症,因此不能单独使用肿瘤标记来诊断癌症。通常,将肿瘤标记测量与其他测试(例如活检)结合使用。

Tumor marker tests used to diagnose cancer include:

CA-125 test

ACA-125 test测量一个人的血液中癌症抗原125(CA-125)的量。CA-125是一种生物标志物或肿瘤标记物的蛋白质。在癌细胞中发现该蛋白质较高,尤其是ovarian cancercells.

Cancer types that may cause higher-than-normal levels of CA-125 include:

Cancer that has spread to the peritoneum, the abdomen’s lining, may also cause higher-than-normal levels of CA-125.

重要的是要注意,除癌症以外的其他疾病可能导致更高水平的CA-125,包括子宫肌瘤,子宫内膜异位症。狼疮。肝病和胰腺炎。

Prostate-specific antigen test

Aprostate-specific antigen (PSA)测试测量血液中的PSA水平。prostate gland produces PSA, a protein that at an elevated level may be a sign of prostate cancer. A high PSA reading also may indicate noncancerous conditions, such as inflammation of the prostate (prostatitis) and enlargement of the prostate (benign prostatic hyperplasia).

Men who have symptoms associated with prostate cancer may have a PSA test along with a digital rectal exam (DRE). According to the National Cancer Institute, research shows that men with prostate cancer may have a low PSA level, while men without prostate cancer may have a high level. One in four men with an elevated PSA level actually has prostate cancer. However, an increase in PSA level over time may indicate prostate cancer. That’s why some men with a high PSA level may be monitored under active surveillance, which involves PSA testing at regular intervals.

癌腹抗原(CEA)

CEA是一种蛋白质,通常不存在健康的成年人。尽管它是由癌细胞产生的,但也可以由其他疾病(例如肝病和炎症性肠病)产生。

Because CEA may be detected in the blood or bodily fluids when cancer is present,CEA测试may be helpful in determining whether you have this disease. However, it doesn’t tell your doctor what kind of cancer you have.

Typically, this test is used to monitor cancers of the:

The higher the concentration of CEA in your blood, the more advanced the cancer is likely to be—so measuring it regularly can help your doctor determine whether or not the cancer is responding to treatment.

Other tumor markers doctors look for when diagnosing and treating cancer include:

Marker Associated cancers Test Comments
α-毒素蛋白(AFP) Liver cancer Blood test Tests may help diagnose and stage cancer, determine treatment options and measure response to treatment.
Beta-2-microglobulin (B2M) 多发性骨髓瘤,慢性淋巴细胞性白血病和一些淋巴瘤 血液,尿液,脊髓液 Tests may help determine response to treatment and prognosis.
Beta-Human绒毛膜促性腺激素(β-HCG) Choriocarcinoma and germ cell tumors 尿液或血液 Tests may help diagnose and stage cancer, determine treatment options and measure response to treatment.
CA15-3/CA27.29 乳腺癌 Blood Tests may help diagnose cancer recurrence and measure response to treatment.
CA19-9 胰cancer, gallbladder cancer, bile duct cancer, and gastric cancer Blood Tests may help measure response to treatment.
降钙素 Thyroid cancer Blood Tests may help diagnose cancer and measure response to treatment.
癌腹抗原(CEA) Colorectal cancer Blood Tests may help diagnose cancer recurrence and measure treatment response.
Chromogranin A (CgA) Neuroendocrine tumors Blood Tests may help diagnose cancer recurrence and measure response to treatment.
HE4 卵巢cancer Blood 测试可能有助于确定治疗方案,监测复发并衡量对治疗的反应。
Immunoglobulins Multiple myeloma and non-Hodgkin lymphoma Blood and urine 测试可能有助于诊断疾病,监测复发并测量对治疗的反应。
Neuron-specific enolase (NSE) 肺cancer Blood 测试可能有助于诊断疾病并衡量对治疗的反应。
核基质蛋白22 Bladder cancer 尿 Tests may help measure response to treatment.
Thyroglobulin Thyroid cancer Blood 测试可能有助于监测对治疗和诊断复发的反应。

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