What tests are needed for tumors

What examinations are needed for tumors? The prevalence of tumors is very high now, and tumors have caused a certain impact on people's work and life. If you feel unwell, you should go to the hospital for examination and treatment in time. What examinations are needed for tumors? Let's learn about it together!

Physical examination

Physical examination is an important part of tumor diagnosis. In addition to detailed and purposeful examination of relevant organs and tissues based on the characteristics of certain symptoms complained by the patient, a systematic whole-body examination and local examination of the tumor are also required.

1. The purpose of the systemic examination is to determine whether the patient has a tumor, whether it is benign or malignant, primary or secondary, whether there is distant metastasis, the function of important organs (heart, lungs, liver, kidneys, central nervous system, bone marrow), and whether the patient can tolerate major surgical treatment, radiotherapy or chemotherapy.

2. Local examination The purpose of local examination is to determine the location of the tumor, its relationship with surrounding tissues and whether it can be treated surgically, with emphasis on examining the mass and regional lymph node involvement.

Laboratory tests

Most tumors have no special symptoms and signs in the early stage, especially malignant tumors of the internal organs, and early diagnosis is very difficult. With the rapid development of molecular biology, cell biology, tumor immunology and tumor serial research, laboratory diagnosis of tumors has made great progress, especially the success of hybridoma technology research and the rise of monoclonal antibody engineering, which provide more reference indicators for early diagnosis of tumors and judgment of therapeutic efficacy. In addition, although routine laboratory tests cannot diagnose tumors, they are indispensable for differential diagnosis and determining tumor treatment plans.

1. Routine examination of blood, urine and stool. Patients with digestive tract tumors often have anemia, with moderate or mild decreases in red blood cell count and hemoglobin, usually normal hemoglobin and normocytic anemia. The presence of a large number of red blood cells in urine is one of the important indications of urinary tract tumors. Blood in stool may be an early sign of gastrointestinal malignancy and should be carefully identified.

2. Sputum examination Sputum direct smear staining for exfoliated cell examination has important practical value for the diagnosis of lung cancer. The diagnosis can be confirmed by finding cancer cells in the smear. According to statistics, the positive rate of sputum smear for lung cancer is about 85%. Therefore, sputum examination is a simple, effective and practical method in the auxiliary diagnosis of lung cancer.

3. Examination of chest and ascites Bloody chest and ascites are the most common signs of abdominal metastasis of lung cancer, liver cancer, gastrointestinal cancer and ovarian cancer. The discovery of cancer cells during smear microscopy can help confirm the diagnosis.

4. Examination of gastric and duodenal fluid Diseases of the stomach and duodenum can lead to changes in the quality and quantity of gastric juice and duodenal drainage fluid. Examination of this secretion can not only help diagnose malignant diseases of the stomach, but also help understand the bile secretion, bile duct status and pancreatic function, thus helping to diagnose gastric, bile duct and pancreatic tumors.

5. Biochemical examination: Carcinogenic factors cause abnormal cell gene expression, leading to cell canceration. Excessive production or abnormally increased activity of certain enzymes or other metabolites can leak out through the cell membrane with increased permeability and enter the blood circulation. Cancer cells can also be destroyed, directly releasing metabolites and various enzymes into the blood circulation. In this way, abnormal metabolites or excessive enzyme activity can be measured from the patient's serum, which is helpful for tumor diagnosis. For example, alkaline phosphatase (AKP) is helpful for the diagnosis of liver cancer, pancreatic head cancer, bile duct cancer and bone metastasis.

6. Tumor markers Chemical substances that can indicate subclinical tumors and are detected from the body fluids or tissue cells by chemical or immunological methods are called tumor markers. Most of the tumor markers currently used are non-specific and have cross-reactions with certain other diseases, so they must be combined with other tests to identify them. Commonly used tumor markers include: alpha-fetoprotein (AFP), which is mainly used to diagnose primary liver cancer and gonadal tumors. AFP levels may also be elevated in very rare secondary liver cancers; carcinoembryonic antigen (cEA), which can be elevated in colorectal cancer, pancreatic cancer, lung cancer, breast cancer, ovarian cancer, etc., and is often used for treatment evaluation and monitoring of tumor recurrence.

Special examinations

1. Imaging examination

(1) Ordinary X-ray examination: Chest X-ray fluoroscopy and filming are simple and easy to detect lung masses. They are essential basic examinations for lung cancer diagnosis. X-ray examination is also needed for the diagnosis of bone, nasopharyngeal and paranasal sinus tumors. Gastrointestinal barium radiography is required for digestive tract tumors. Urinary tract and biliary tract angiography is helpful for the diagnosis of urinary tract tumors and biliary tract tumors. Early diagnosis of breast tumors is also inseparable from X-ray examination. In addition, angiography of various parts of the body also requires X-ray examination.

(2) Type B ultrasound examination: It can display the morphology and activity status of human soft tissues. It is harmless, painless, inexpensive and easy to operate. It is the preferred diagnostic method for initial screening of tumors, especially for tumors of the liver, pancreas, gallbladder, thyroid and genitourinary system.

(3) Radionuclide examination: Commonly used radionuclides in clinical practice include 32P, 131I, 198Au, 113In, 99Tc, 67Ga, etc. For example, when 198Au is used to diagnose liver cancer, it can show a filling defect area or space-occupying lesions at the lesion site; when 67Ga is used to diagnose lung cancer, a concentrated radioactive "hot zone" can be seen at the lesion site. However, radionuclide examination is not the only specific diagnosis of tumors, because liver cysts and liver abscesses can also have space-occupying lesions, and lung inflammation can also show "hot zones" of radioactive concentration. Therefore, it must be combined with other clinical examinations and a comprehensive analysis to make a correct diagnosis. Now 99Tc is commonly used for whole-body bone imaging, which can detect bone metastasis and primary bone tumors at an early stage.

(4) CT: The anatomical images have high spatial resolution and contrast resolution. Cross-sectional tomography can avoid image overlap and can detect early smaller tumors. In particular, it can directly display the anatomical structure of the abdominal solid organs. For example, the clinical diagnosis of pancreatic cancer is very difficult. With CT, the diagnosis rate can be greatly improved.

(5) MRI: It has higher tissue resolution than CT and can monitor the body's biochemical metabolic process like radionuclide examination. It can also observe blood vessels and even blood flow speed and direction without contrast agents. MRI is more effective in diagnosing tumors of the central nervous system, head and neck, spine, limbs, bones and joints, and pelvic cavity. It is better than CT and B-ultrasound in qualitative diagnosis of abdominal lesions such as intrahepatic space-occupying lesions and distinguishing benign and malignant tumors: MRI is most effective in distinguishing hilar masses from blood vessels or lymph nodes, and is valuable in diagnosing lung cancer invading the mediastinum, large blood vessels, and chest wall. MR angiography (MRA) is a newly developed technology in recent years that can display intracranial blood vessels and pulmonary artery system in three dimensions.

(6) PET: It is the most advanced imaging technology in nuclear medicine. Clinical examinations are mainly used in the fields of tumors, cardiovascular diseases, and nervous system diseases. Since cancerous tissues absorb a large amount of F-FDG (fluorodeoxyglucose), PET can diagnose tumors early and accurately, and can accurately stage them. The diagnostic accuracy is higher than other current technologies.

2. Endoscopic examinations currently used in clinical practice include esophagoscopes, gastroscopes, bronchoscopes, colonoscopes, rectoscopes, laryngoscopes, nasopharyngeal scopes, cystoscopes, laparoscopes, mediastinoscopes, hysteroscopes, and choledochoscopes. They are of great help in diagnosing tumors in the examined area. Tissue biopsies or cell brushing can be performed under direct endoscopic vision for further examination.

3. Pathological examination Pathological examination is one of the most accurate methods to diagnose tumors, which includes exfoliated cell examination, tissue print staining examination, and pathological section examination (including frozen section and rapid section method).

(1) Exfoliated cell examination: mainly collect sputum, gastric juice, pleural effusion, ascites, urine, vaginal secretions, etc., centrifuge or directly smear, and use special staining method to find cancer cells under the microscope. This method is simple, easy, economical and safe, and the diagnosis rate can reach 75% to 85%. This method is suitable for cancer prevention screening and can be promoted in rural areas.

(2) Tissue printing method: It is roughly the same as the exfoliated cell examination method, but the difference is that the cross-section of the resected tumor is directly printed on a glass slide and examined under a microscope after special staining. Its positive rate is slightly higher than that of the exfoliated cell method, and its accuracy rate is about 90%.

(3) Pathological section examination: It is the most accurate diagnostic method, but it is not 100% accurate. There are bite biopsy, incisional biopsy, excisional biopsy and other methods. Scrape biopsy is mostly used for tumors on the surface of lumps, fistulas, cervix, etc. A tongue depressor or spatula can be used to gently scrape off tissue on the surface of the tumor. Both cytological examination and pathological section examination can be performed.

The above are various examinations and auxiliary examinations for diagnosing tumors. You should do the corresponding examinations under the guidance of a doctor, because each doctor will have his own ideas, and you don’t have to do all of them. The above examinations can provide you with a reference so as not to think that the doctor charges randomly or to avoid the doctor charging randomly. Finally, patients diagnosed with tumors should maintain a good attitude and actively cooperate with the doctor's treatment, and recover soon.