Common abnormal indicators in physical examinations such as ground-glass opacity (GGO) in the lungs, nodule changes and elevated tumor markers often spark significant concern.
Today, we exclusively invite Professor Yang Nong, a renowned domestic expert in lung cancer diagnosis and treatment and a distinguished expert at Hainan Cancer Hospital, to provide professional insights into common questions raised by lung cancer patients.
Q1: For patients with GGO, is PET-CT examination necessary?
Professor Yang Nong: PET-CT is not a universal requirement for all patients with pulmonary GGO. For pure GGO smaller than 1 cm in diameter, PET-CT has limited diagnostic value. A more appropriate approach is continuous CT observation. Usually high-definition plain CT supplemented by 3D reconstruction when necessary is desirable. Under favorable equipment conditions, contrast enhancement is rarely required.
Experienced physicians can make accurate judgments by continuously reviewing images and monitoring the dynamic changes of GGO. PET-CT is primarily indicated for evaluating the nature of solid nodules larger than 7 mm, detecting distant metastases, local lymph node involvement, and defining tumor extent.
Q2: A small pulmonary nodule detected the year before last disappeared this year. What could be the cause?
Professor Yang Nong: Diseases causing pulmonary nodules are categorized into infectious and non-infectious types. Infectious causes include bacterial, fungal, mycoplasmal, chlamydial, viral, and tuberculous infections, with recent influenza outbreaks also potentially playing a role. Non-infectious etiologies include interstitial pneumonia, sarcoidosis, etc.
It should be noted that cancer does not spontaneously regress. In cases of nodule disappearance, consecutive imaging studies must be reviewed, and the patient’s epidemiological history must be thoroughly investigated.
Q3: Does an elevated tumor marker in a physical examination signal cancer risk?
Professor Yang Nong: Current tumor diagnosis relies less on tumor markers. Among physical examination, CEA (carcinoembryonic antigen) remains a key indicator.
The normal upper limit for non-smokers is typically 0–5, and 0–10 for smokers. People should focus on trend changes. If the result jumps from 0 or 5 to over 100 or even 200 within three months and continues to rise, then this result is highly significant. Fluctuations between teens and twenties (e.g., 15→22→14) carry little clinical meaning.
The Key point is thattumor marker tests must be conducted on the same equipment, under identical physical conditions, and using the same protocol to ensure result comparability.
In addition to CEA, adenocarcinoma patients often exhibit elevations in multiple tumor markers, rarely in isolation. If a marker shows a dramatic increase alongside 2–3 other abnormal markers, heightened vigilance is required. Mere numerical fluctuations without a consistent upward trend warrant less concern, as benign proliferative diseases or even infections can cause marker elevations, limiting their diagnostic specificity.
Q4: Should we be alarmed if multiple cancers occur in a family?
Professor Yang Nong: Consecutive cases of cancer (regardless of type) in a family necessitate close attention.
On one hand,family members living together may have identical lifestyles or exposure to the same harmful substances, which could exert common impacts on the whole family.
On the other hand, the family may carry a susceptible gene, which increases disease susceptibilitywhen combined with environmental triggers. Clinicians typically trace the entire family pedigree upon identifying such cases.
Expert introduction
Consultation Information
[Consultation Time] June 7th, morning, Sixth Consultation Area, Hainan Cancer Hospital
[Appointment Registration] Follow Hainan Cancer Hospitals official WeChat account for “appointment registration”
[Health Consultation] 13876807106
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2. Accompanying direct relatives (with decision-making authority)
3. Relevant previous examination results, organized chronologically
4. Paper medical records from previous consultations
5. Surgical case slides, wax blocks, or 20-30 glass slides
6. Pathological diagnosis report
7. Hospitalization medical records
8. Recent relevant examination results
9. The patients current treatment plan
10. The most urgent questions to consult