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手把手教你分析检验报告单，肿瘤标志物案例

2018-07-02 labmed 检验医学网

肿瘤标志物检验报告单案例
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53岁女性，曾经吸烟，无疾病史，常规胸部X线检查发现肺部阴影。


作者：王启杰

53岁女性，曾经吸烟，无疾病史，常规胸部X线检查发现肺部阴影。

报告：CA15.3显著升高、CEA升高幅度较小，提示肿瘤。我们的首要建议是排除乳腺或肺癌(腺癌)。

诊断：肺Ila期腺癌。

评论：CA15.3具有高度特异性。在严重肝病时可出现轻度升高，一般低于75-100U/ml。超过这个水平高度提示肿瘤。多种肿瘤均可出现CA15.3升高：乳腺、肺、卵巢或子宫内膜。如果CA125结果为阴性，则不大可能为妇科腺癌(卵巢、子宫内膜)。根据上述结果不大可能区分肿瘤；是来源于乳腺还是肺。其他可能有帮助的TMs包括HER 2/neu或HE-4。很高水平的HER-2/neu ( >30ng/mI )高度提示乳腺癌；而高浓度的HE-4主要提示为肺来源，因为乳腺肿瘤结果为阴性。如果是肺肿瘤，则CA15.3和CEA升高强烈提示为腺癌。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1841259, encodeId=079a18412597a, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Mon May 20 16:17:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1668603, encodeId=4d221668603fa, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Sun Dec 23 04:17:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1967507, encodeId=96ce196e50739, content=<a href='/topic/show?id=453a625828f' target=_blank style='color:#2F92EE;'>#检验报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62582, encryptionId=453a625828f, topicName=检验报告单)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d521144, createdName=wrj0121, createdTime=Mon Aug 20 16:17:00 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1956997, encodeId=5876195699e10, content=<a href='/topic/show?id=00fe62580f6' target=_blank style='color:#2F92EE;'>#检验报告#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62580, encryptionId=00fe62580f6, topicName=检验报告)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd32500118, createdName=644982816_68283321, createdTime=Fri Mar 15 19:17:00 CST 2019, time=2019-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=329838, encodeId=23e53298380c, content=谢谢告知, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/CD9641ADF96717CB416B573C11E408F8/100, createdBy=989a2332121, createdName=hahalu, createdTime=Fri Jul 06 23:16:49 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=329175, encodeId=9fb83291e5e7, content=谢谢分享知识.有学习了一点, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aadd1680584, createdName=蔬菜, createdTime=Wed Jul 04 07:15:48 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328790, encodeId=cd92328e906f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Mon Jul 02 20:44:51 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
    2019-05-20 hukaixun

    #标志物#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1841259, encodeId=079a18412597a, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Mon May 20 16:17:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1668603, encodeId=4d221668603fa, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Sun Dec 23 04:17:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1967507, encodeId=96ce196e50739, content=<a href='/topic/show?id=453a625828f' target=_blank style='color:#2F92EE;'>#检验报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62582, encryptionId=453a625828f, topicName=检验报告单)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d521144, createdName=wrj0121, createdTime=Mon Aug 20 16:17:00 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1956997, encodeId=5876195699e10, content=<a href='/topic/show?id=00fe62580f6' target=_blank style='color:#2F92EE;'>#检验报告#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62580, encryptionId=00fe62580f6, topicName=检验报告)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd32500118, createdName=644982816_68283321, createdTime=Fri Mar 15 19:17:00 CST 2019, time=2019-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=329838, encodeId=23e53298380c, content=谢谢告知, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/CD9641ADF96717CB416B573C11E408F8/100, createdBy=989a2332121, createdName=hahalu, createdTime=Fri Jul 06 23:16:49 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=329175, encodeId=9fb83291e5e7, content=谢谢分享知识.有学习了一点, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aadd1680584, createdName=蔬菜, createdTime=Wed Jul 04 07:15:48 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328790, encodeId=cd92328e906f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Mon Jul 02 20:44:51 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
    2018-12-23 zlawrance

    #报告单#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1841259, encodeId=079a18412597a, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Mon May 20 16:17:00 CST 2019, time=2019-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1668603, encodeId=4d221668603fa, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Sun Dec 23 04:17:00 CST 2018, time=2018-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1967507, encodeId=96ce196e50739, content=<a href='/topic/show?id=453a625828f' target=_blank style='color:#2F92EE;'>#检验报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62582, encryptionId=453a625828f, topicName=检验报告单)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d521144, createdName=wrj0121, createdTime=Mon Aug 20 16:17:00 CST 2018, time=2018-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1956997, encodeId=5876195699e10, content=<a href='/topic/show?id=00fe62580f6' target=_blank style='color:#2F92EE;'>#检验报告#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62580, encryptionId=00fe62580f6, topicName=检验报告)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd32500118, createdName=644982816_68283321, createdTime=Fri Mar 15 19:17:00 CST 2019, time=2019-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=329838, encodeId=23e53298380c, content=谢谢告知, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/CD9641ADF96717CB416B573C11E408F8/100, createdBy=989a2332121, createdName=hahalu, createdTime=Fri Jul 06 23:16:49 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=329175, encodeId=9fb83291e5e7, content=谢谢分享知识.有学习了一点, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aadd1680584, createdName=蔬菜, createdTime=Wed Jul 04 07:15:48 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328790, encodeId=cd92328e906f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Mon Jul 02 20:44:51 CST 2018, time=2018-07-02, status=1, ipAttribution=)]
    2018-08-20 wrj0121

    #检验报告单#

    0

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    2019-03-15 644982816_68283321

    #检验报告#

    0

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    2018-07-06 hahalu

    谢谢告知

    0

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    2018-07-04 蔬菜

    谢谢分享知识.有学习了一点

    0

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    2018-07-02 医者仁心5538

    学习了

    0

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