Methods for diagnosing oncological diseases

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Methods for diagnosing oncological diseases

1. Clinical inspection and anamnesis

The first stage in the diagnosis of oncological diseases is a thorough clinical examination and collecting anamnesis. The doctor asks questions about the patient’s complaints, the time of their appearance, character, intensity, factors that enhance or reduce symptoms. Information about the hereditary predisposition to cancer, the diseases, bad habits (smoking, alcohol consumption), professional harmfulness and lifestyle is important.

Physical examination includes a visual examination of the skin and mucous membranes for neoplasms, ulcerations, color changes. Palpation of the lymph nodes, thyroid gland, mammary glands (in women), the prostate gland (in men) and other organs to detect seals, soreness, and dimensions are carried out. Auscultation of the lungs and heart allows you to identify noises, wheezing, which can be associated with the tumor process. The percussion of the abdomen helps to determine the size of the liver, spleen and other organs.

Clinical examination and anamnesis give the doctor a preliminary idea of ​​a possible diagnosis and allow you to plan a further examination. It is important to note that the results of the clinical inspection are not sufficient to make a final diagnosis, but only indicate the need for additional research.

2. Laboratory diagnostic methods

Laboratory diagnostic methods play an important role in identifying cancer, assessing the degree of their spread and monitoring the effectiveness of treatment. They include various tests of blood, urine, feces, as well as the study of biopsy material.

2.1. General blood test

A general blood test allows you to evaluate the general condition of the body, to identify signs of inflammation, anemia, thrombocytopenia or leukocytosis. Changes in blood indicators may indicate the presence of a tumor process, but they are not specific for cancer. For example, anemia can be caused by bleeding from the tumor of the gastrointestinal tract, and leukocytosis-inflammation associated with the decay of the tumor.

2.2. Biochemical blood test

Biochemical blood test allows you to evaluate the function of various organs and systems, such as liver, kidneys, pancreas. An increase in the level of liver enzymes (ALT, AST, alkaline phosphatase, GGTP) may indicate metastases to the liver. A change in the level of creatinine and urea may indicate a violation of the function of the kidneys caused by the tumor or its treatment. An increase in the level of amylase and lipase may indicate a pancreatic tumor.

2.3. Blood test for cancer markers

Oncomarkers are substances that are produced by tumor cells or body cells in response to the presence of a tumor. Their level in the blood can be increased with various types of cancer. However, it is important to note that cancer cancer is not absolutely specific for cancer, and their level can be increased in some benign diseases. Therefore, analysis for cancer markers is used in combination with other diagnostic methods.

The most common cancer markers:

  • PSA (prostatic specific antigen): Used to diagnose prostate cancer.
  • CA 125 (Cancer Antigen 125): Used to diagnose ovarian cancer.
  • CEA (cancer embryonic antigen): Used to diagnose cancer of the colon, lungs, stomach and other organs.
  • AFP (alpha-fetoprotein): Used to diagnose liver cancer and herminogenic tumors.
  • HCG (human chorionic gonadotropin): Used to diagnose germinogenic tumors.
  • CA 19-9 (Cancer Antigen 19-9): Used to diagnose pancreatic cancer, colon and stomach.
  • HE4 (Human Epididymis Protein 4): Used to diagnose ovarian cancer (combined with CA 125).
  • NSE (neuron-specific enolase): Used to diagnose fine cell cancer and neuroblastoma.
  • SCC (antigen of plane cell carcinoma): It is used to diagnose flat -cell cancer of the cervix, lungs, head and neck.

2.4. Urine analysis

Urine analysis can identify signs of kidney damage, bladder and urinary tract. The presence of blood in the urine (hematuria) may indicate a tumor of the bladder or kidneys. A cytological study of urine allows you to identify tumor cells in the urine.

2.5. Hidden Blood Analysis

The analysis of feces for hidden blood is used to detect bleeding from the gastrointestinal tract, which can be caused by the tumor of the colon or stomach. A positive result of analysis requires colonoscopy or gastroscopy to detect a source of bleeding.

2.6. Cytological study

A cytological study is a microscopic examination of cells obtained from various sources (for example, sputum, pleural fluid, ascetic fluid, flushing from the surface of the tumor). It allows you to identify tumor cells and determine their type. A cytological study is an important method for diagnosing lung cancer, cervical cancer and other types of cancer.

2.7. Histological study

A histological examination is a microscopic examination of the tissue obtained by biopsy or surgical removal of the tumor. It allows you to establish the final diagnosis of cancer, determine its type, degree of malignancy and prevalence. A histological study is a “gold standard” in the diagnosis of cancer.

3. Instrumental diagnostic methods

Instrumental diagnostic methods allow you to visualize the tumor and evaluate its size, location, structure and degree of distribution. They include various methods of radiological examination, ultrasound, endoscopic examination and radioisotopic examination.

3.1. Radiography

X -ray is a diagnostic method based on the use of x -rays. It allows you to visualize bones, lungs, heart and other organs. The x -ray of the chest is used to detect lung tumors, metastases in lungs and other diseases. Bone radiography is used to identify bone tumors and metastases in bones. To improve the visualization of soft tissues, contrasting substances can be used (for example, bariums for studying the gastrointestinal tract, iodine-containing drugs for kidney and urinary tract research).

3.2. Computed tomography (CT)

Computed tomography (CT) is a diagnostic method that uses x -rays to obtain a series of transverse images of the body. CT allows you to get a more detailed image of organs and tissues than ordinary radiography. CT is used to diagnose lung tumors, liver, kidneys, pancreas, brain and other organs. CT with contrast amplification allows you to improve the visualization of tumors and evaluate their blood supply.

3.3. Magnetic resonance tomography (MRI)

Magnetic resonance imaging (MRI) is a diagnostic method that uses a magnetic field and radio waves to obtain images of organs and tissues. MRI allows you to get very detailed images of soft tissues, such as the brain, spinal cord, mammary glands, prostate iron and muscles. MRI is used to diagnose tumors of the brain, spinal cord, mammary glands, prostate gland and other organs. MRI with contrast enhancing allows you to improve the visualization of tumors and evaluate their blood supply.

3.4. Ultrasound examination (ultrasound)

Ultrasound examination (ultrasound) is a diagnostic method that uses ultrasonic waves to obtain images of organs and tissues. Ultrasound is a safe and non -invasive diagnostic method. Ultrasound is used to diagnose tumors of the liver, kidneys, thyroid gland, mammary gland, prostate gland and other organs. Doppler ultrasound allows you to evaluate the blood flow in the vessels. Endoscopic ultrasound (Eusta) allows you to obtain more detailed images of the organs of the gastrointestinal tract and pancreas.

3.5. Endoscopic research methods

Endoscopic research methods allow you to visualize internal organs using an endoscope – a flexible tube with a camera at the end. They include gastroscopy, colonoscopy, bronchoscopy, cystoscopy and other methods.

  • Gastroscopy Allows you to visualize the esophagus, stomach and duodenum. It is used to diagnose tumors of the esophagus, stomach and duodenum, as well as for taking a biopsy.
  • Colonoscopy Allows you to visualize the colon. It is used to diagnose tumors of the colon, polyps and other diseases, as well as for taking a biopsy and removing polyps.
  • Bronchoscopy Allows you to visualize the trachea and bronchi. It is used to diagnose tumors of the lungs, inflammatory diseases of the lungs and other diseases, as well as to take a biopsy and remove foreign bodies.
  • Cystoscopy Allows you to visualize the bladder. It is used to diagnose tumors of the bladder, inflammatory diseases of the bladder and other diseases, as well as for taking a biopsy and removing stones.

3.6. Radioisotope research methods

Radioisotope research methods use radioactive isotopes to obtain images of organs and tissues. They include scintigraphy, positron emission tomography (PET) and single-photon emission computed tomography (OFECT).

  • Scintigraphy Allows you to evaluate the function of organs and tissues. It is used to diagnose tumors of bones, thyroid gland, lungs, liver and other organs.
  • Positron emission tomography (PET) Allows you to visualize metabolic processes in the body. It is used to diagnose tumors of the brain, lungs, colon, mammary gland and other organs, as well as to evaluate the effectiveness of treatment. PET is often combined with CT (PET/CT) to obtain more accurate information about the location and prevalence of the tumor.
  • Single -photon emission computed tomography (OFECT) Allows you to evaluate the function of organs and tissues. It is used to diagnose heart disease, brain, bones and other organs.

3.7. Biopsy

A biopsy is a procedure in which a tissue is taken for histological examination. The biopsy is a necessary step in making the final diagnosis of cancer. There are various types of biopsy:

  • Insulinating Biopsy: A small piece of tumor fabric is taken.
  • Excisio biopsy: The whole tumor or suspicious education is removed.
  • Thin -iginal aspiration biopsy (tab): With the help of a thin needle, a small number of tumor cells are taken.
  • Tolstoigal biopsy (trepan-biopsy): With the help of a thick needle, a column of fabric from the tumor is taken.
  • Endoscopic biopsy: The biopsy is taken during an endoscopic examination.
  • Surgical biopsy: The biopsy is taken during a surgical operation.

4. Molecular genetic diagnostic methods

Molecular genetic diagnostic methods allow you to identify genetic changes in tumor cells that can be used to diagnose, predict the course of the disease and choose the most effective treatment. They include various methods of analysis of DNA, RNA and proteins.

4.1. Polymerase chain reaction (PCR)

Polymerase chain reaction (PCR) is a method of amplification (multiplication) of a certain DNA section. PCR is used to identify mutations in genes related to cancer, as well as to determine the viral load for the-associated crayfish (for example, cervical cancer caused by the human papillomavirus).

4.2. DNA sequencing

DNA sequencing is a method for determining the sequence of nucleotides in DNA. DNA sequencing is used to identify mutations in genes related to cancer, as well as to determine the genetic profile of the tumor.

4.3. Fluorescent in situ hybridization (Fish)

Fluorescent in situ hybridization (FISH) is a method that uses fluorescent-aged DNA zonds to identify certain areas of DNA in cells. Fish is used to identify chromosomal aberrations (for example, translocations, delections, amplification), which can be associated with cancer.

4.4. Immunogymic study (IGC)

Immunogymic study (IGC) is a method that uses antibodies to detect certain proteins in tissue. The IGC is used to determine the type of tumor, the degree of its malignancy and predict the course of the disease. The IGC is also used to determine the expression of receptors to hormones (for example, estrogen and progesterone receptors for breast cancer) and HER2 (a receptor of an epidermal growth factor of a person 2) with breast and stomach cancer.

4.5. Protocol-cytometric analysis

Processing and cytometric analysis is a method that allows you to analyze individual cells in the stream. It is used to determine the number of cells expressing certain superficial markers, as well as to determine the fertility of cells (the amount of chromosomes). Processing and cytometric analysis is used to diagnose leukemia and lymph.

4.6. Analysis Microchip (DNA-Microcipp)

Analysis of microchips (DNA microchips) is a method that allows you to simultaneously analyze the expression of thousands of genes in the cell. Analysis of microchips is used to determine the genetic profile of the tumor and predict the course of the disease.

4.7. Liquid biopsy

Liquid biopsy is a method that allows you to identify tumor cells or tumor DNA in the blood or other biological fluids (for example, urine, spinal fluid). Liquid biopsy is a non -invasive diagnostic method, which can be used for early diagnosis of cancer, monitor the effectiveness of treatment and detection of relapse.

5. Diagnosis of certain types of cancer

Diagnostic methods differ depending on the type of cancer. Below are examples of diagnostic methods for some common types of cancer:

5.1. Lung cancer

  • Chest radiography
  • Computer tomography (CT) of the chest
  • Bronchoscopy with a biopsy
  • Cytological examination of sputum
  • Thoracocentesis (in the presence of pleural effusion) with a cytological examination of pleural fluid
  • Biopsy of the lymph nodes of the mediastinum (mediastinoscopy, endoscopic ultrasound with biopsy)
  • PET/CT (to determine the prevalence of a tumor)
  • Molecular genetic study of the tumor (to determine mutations in the genes EGFR, Alk, ROS1, etc.)

5.2. Breast cancer

  • Self -examination of the mammary glands
  • Clinical examination of the mammary glands by a doctor
  • Mammography
  • Ultrasound examination (ultrasound) of the mammary glands
  • Magnetic resonance imaging (MRI) of the mammary glands
  • Breast biopsy (fine -iginal aspiration biopsy, thick -iginal biopsy, surgical biopsy)
  • Immunohistochemical examination of the tumor (to determine the expression of estrogen receptors, progesterone and HER2)
  • Determination of the stage of cancer (includes examination and palpation of lymph nodes, chest radiography, abdominal ultrasound, bone scan, PET/CT)

5.3. Tolstoy’s cancer

  • Hidden Blood Analysis
  • Colonoscopy with a biopsy
  • Virtual colonoscopy (CT-kolonography)
  • Irrigoscopy (X -ray examination of the colon with contrast agent)
  • Computed tomography (CT) of the abdominal cavity and small pelvis (to determine the prevalence of a tumor)
  • MRI of the abdominal cavity and small pelvis (to determine the prevalence of a tumor)
  • PET/CT (in some cases)
  • Determination of the stage of cancer (includes examination and palpation of lymph nodes, chest radiography, abdominal ultrasound, KT of the chest and abdominal cavity)
  • The molecular genetic study of the tumor (to determine the mutations in the genes Kras, Nras, Braf, etc.)

5.4. Prostate cancer

  • Finger rectal examination
  • Determination of the level of prostatic specific antigen (PSA) in the blood
  • Transrectal ultrasound examination (Trust) of the prostate gland
  • Prostate biopsy (under Trusian control)
  • Prostate MRI (to determine the prevalence of a tumor)
  • Bone scanning (to detect metastases in bones)
  • PET/CT with PSMA (prostatic specific membrane antigen) (to determine the prevalence of a tumor, especially for relapse)
  • Determining the stage of cancer (includes examination and palpation of lymph nodes, scanning bones, CT of the chest and abdominal cavity)
  • The molecular genetic study of the tumor (in some cases, to determine mutations in the genes of BRCA1, BRCA2, ATM, etc.)

5.5. Stomach cancer

  • Biopsy gastroscopy
  • Endoscopic ultrasound (eusy) of the stomach
  • Computed tomography (CT) of the abdominal cavity and small pelvis (to determine the prevalence of a tumor)
  • MRI of the abdominal cavity and small pelvis (to determine the prevalence of a tumor)
  • PET/CT (in some cases)
  • Determination of the stage of cancer (includes examination and palpation of lymph nodes, chest radiography, abdominal ultrasound, KT of the chest and abdominal cavity)
  • Immunohistochemical examination of the tumor (to determine the expression of HER2)

6. Conclusion

Diagnosis of cancer is a complex and multi -stage process that requires the use of various research methods. The choice of diagnostic methods depends on the type of cancer, its localization, stage and general condition of the patient. Early cancer diagnosis is a key factor for successful treatment and improvement in prognosis. The development of new diagnostic methods, such as liquid biopsy and molecular genetic studies, allows you to identify cancer in earlier stages and select the most effective treatment for each patient. It is important to note that all diagnostic procedures should be performed by qualified medical personnel using modern equipment and in accordance with established standards. Regular medical examinations and timely seeking a doctor when suspicious symptoms occur are important measures for the prevention and early diagnosis of cancer.

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