Doctors Reminder:
After receiving the health check-up report, if the following words appear, you should be vigilant and investigate the possibility of cancer. If necessary, you can consult a specialist for further examination and investigation.
However, it should be emphasized that these signals are just a hint. They need to be taken seriously, but it is not possible to simply conclude that one has cancer based on the initial report.
01
Signals in the Lab Report
Blood Routine Test
The blood routine test is a routine examination and is not used to screen for cancer. However, if there are obvious abnormal indicators (elevated or reduced) in the blood routine test report, further examination is needed.
Excluding the influence of factors such as infection, trauma, stress, and medication, if there is a significant increase in neutrophils or monocytes in the white blood cell classification, accompanied by a decrease in hemoglobin (anemia) and a reduction in platelets (easy bleeding), one should be vigilant about the possibility of acute non-lymphocytic leukemia or chronic myeloid leukemia.
If the white blood cells, mainly lymphocytes, are significantly elevated, it is important to investigate the possibility of lymphocytic leukemia.
A decrease in white blood cells, red blood cells, and platelets simultaneously (pancytopenia) can be seen in all types of acute leukemia, as well as in myelodysplastic syndromes or aplastic anemia.
In addition, non-hematologic malignancies may sometimes present with a significant increase in white blood cells.
An elevated platelet count can also be seen in non-hematologic malignancies such as lung cancer and colorectal cancer.
Many cancers may present with decreased hemoglobin levels (anemia) when they reach a certain stage.
Biochemical Blood Tests
Biochemical blood tests are also routine examinations, mainly including liver and kidney function, as well as blood glucose, blood lipids, and electrolytes. Abnormalities in some indicators should also raise suspicion of cancer and require further examination for investigation.
• Abnormalities in liver function, such as alanine aminotransferase (ALT) and bilirubin, usually indicate diseases of the liver, gallbladder, or pancreas, which may include malignancies. (Note that the liver has a strong compensatory capacity, and it is possible for the liver to have significant problems while liver function tests remain normal.) For abnormal liver function indicators, further examination is needed to investigate diseases of the liver, gallbladder, and pancreas, including malignancies such as liver cancer, cholangiocarcinoma, and pancreatic cancer.
• If there is a significant abnormality in kidney function, further examination is required to identify the cause, including kidney dysfunction caused by malignancies.
• A marked elevation in alkaline phosphatase should prompt investigation for bone tumors (including primary bone tumors and bone metastases from other cancers) and liver tumors.
• Hypercalcemia may occur due to bone destruction from tumor bone metastasis.
• Lactate dehydrogenase (LDH) is nonspecific. In terms of tumors, it may be significantly elevated in various hematologic and lymphatic system malignancies, such as leukemia, lymphoma, and multiple myeloma. It is associated with tumor proliferation and infiltration, disease severity, and tumor burden, and can be used to assist in diagnosis, therapeutic monitoring, and prognostic evaluation.
Important Reminder
None of these tests are specific. Never simply equate their abnormalities with cancer. Further examination is needed to confirm the cause or rule out the possibility of cancer.
Tumor Markers
Elevated tumor markers do not necessarily indicate cancer, and individuals with cancer may also have normal tumor marker levels. If a health check-up reveals elevated tumor markers, it is advisable to consult a specialist in oncology. The doctor will analyze the situation based on various factors. Some cases may only require regular follow-up and re-examination, while others may need further targeted investigations.
02
Imaging Signals
Ultrasound Examination
Ultrasound examinations, including B-mode ultrasound and color Doppler ultrasound, are primarily used in health check-up to inspect the thyroid, superficial lymph nodes, breast, heart, liver, gallbladder, pancreas, spleen, urinary system (kidneys, ureters, bladder, prostate, etc.), and in women, the uterus, ovaries, and fallopian tubes.
If the ultrasound report contains the following terms, be vigilant for the possibility of malignancy: solid nodule, irregular margins (with angles, spicules, etc.) or unclear, irregular shape, and abundant blood flow signals. However, it is crucial not to make a simple one-to-one correlation.
CT Examination
CT is mainly used for lung cancer screening. Pulmonary nodules detected by lung CT can be categorized into three types: solid nodules, part-solid nodules, and ground-glass nodules.
The assessment of nodule characteristics in imaging requires a comprehensive analysis incorporating factors such as size, shape, density, and trend of change. For nodules that are more likely to be benign, there is no need for excessive concern, but follow-up and re-examination are still necessary. However, if a pulmonary nodule has spicules, lobulation, irregular margins, rapid growth, pleural changes, vascular signs, or solid components within a ground-glass opacity, the possibility of malignancy should be suspected.
This primarily refers to primary lung cancer, but if it is a pulmonary metastasis from other cancers, the manifestations would be different.
Naturally, this merely constitutes a preliminary analysis. Should a pulmonary nodule be identified, it is imperative to seek consultation in specialized departments like thoracic surgery or respiratory medicine, irrespective of the specifics, to conduct further examinations or attain a definitive diagnosis.
Other Imaging Examinations
Examinations such as MRI, PET-CT, and bone ECT are usually not the first choice for routine health check-up. They are more often used for further investigation or screening when abnormalities are detected in other tests, such as ultrasound or CT.
03
Endoscopic Signals
Gastroscopy and colonoscopy are mainly used for screening esophageal and gastric cancer, and colorectal cancer, respectively.
Unlike other tests, if suspicious abnormal lesions are found during endoscopy, the endoscopist will take a biopsy during the examination, unless there are specific contraindications, and send it for pathological examination. A preliminary diagnosis can be made once the pathological results are available.
We would like to remind everyone again that for any abnormalities detected during a health check-up, it is essential to consult a professional doctor. If there is a suspicion of cancer, it is even more crucial to see a specialist. The doctor will analyze all relevant information to provide a diagnosis.
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Source | CCTV News, China Science Communication
Editor | Huang Fei