“媽?zhuān)EA高了3.2個(gè)點(diǎn)，醫(yī)生讓查胃腸鏡！”女兒舉著體檢報(bào)告追下樓時(shí)，陳阿姨正拎著菜籃子要出門(mén)。

50歲的她剛退休，每天雷打不動(dòng)跳兩小時(shí)廣場(chǎng)舞，晚上能啃半只醬鴨，連頭疼腦熱都少見(jiàn)。

“就高3.2？”她掃了眼報(bào)告上的“8.2ng/ml”，笑著把單子塞進(jìn)圍裙口袋?！皡⒖贾?-5，這點(diǎn)誤差不算啥。你李叔血糖高1個(gè)點(diǎn)，現(xiàn)在還天天喝啤酒呢?！?/p>

說(shuō)完轉(zhuǎn)身往菜市場(chǎng)走，要給外孫買(mǎi)剛上市的草莓。

陳阿姨的體檢是女兒“逼”著去的。

“單位年年組織，我身體好得很?！彼傉f(shuō)。但今年女兒剛在消化科規(guī)培結(jié)束，非讓她加了項(xiàng)腫瘤標(biāo)志物篩查——這是她第一次查CEA（癌胚抗原）。

拿到報(bào)告那天，其他指標(biāo)都亮著“正?！?，唯獨(dú)CEA那一欄標(biāo)著“8.2ng/ml”。

女兒盯著醫(yī)生手寫(xiě)的“建議完善胃腸鏡”，急得聲音發(fā)顫：“我們科上周收了個(gè)病人，CEA就高3個(gè)點(diǎn)，查出來(lái)是直腸癌早期！”

陳阿姨卻犯了怵。

鄰居王姐做過(guò)腸鏡，說(shuō)喝瀉藥“拉得直不起腰”，還得清腸到“拉水才算完”。

她偷偷把報(bào)告藏在衣柜最底層，直到女婿找體檢單報(bào)銷(xiāo)時(shí)翻出來(lái)，一家人圍著她磨了三天，才硬把她塞進(jìn)醫(yī)院的腸鏡室。

三天后病理報(bào)告出來(lái)：腺癌。腹部強(qiáng)化CT提示：其他臟器無(wú)轉(zhuǎn)移。

主治醫(yī)生指著片子說(shuō)：“這癌長(zhǎng)在升結(jié)腸，位置偏右，腸腔寬得很，就算長(zhǎng)到3cm都不會(huì)堵，更不會(huì)疼。等你覺(jué)得肚子疼、便血，癌細(xì)胞早跑遍腹腔了?！?/p>

為啥沒(méi)癥狀的癌，偏被這指標(biāo)揪出來(lái)了？

手術(shù)后第五天，陳阿姨坐在病床上翻體檢單，還是想不通：“我啥感覺(jué)沒(méi)有，這8.2到底是啥意思？”

主治醫(yī)生拿了張腸道解剖圖，指著升結(jié)腸的位置解釋?zhuān)?/p>

“CEA就像腸道里的‘哨兵’，正常情況下躲在細(xì)胞里，血液里含量很少（一般<5ng/ml）。但細(xì)胞癌變時(shí)，這‘哨兵’會(huì)跑到血液里，指標(biāo)就高了。”

可這“哨兵”不算“精準(zhǔn)”——吸煙的人、有胃炎的人、甚至剛感冒的人，CEA都可能輕度升高。

也正因如此，很多人像陳阿姨這樣，覺(jué)得“高一點(diǎn)點(diǎn)是誤差”。

臨床數(shù)據(jù)里，右半結(jié)腸癌被發(fā)現(xiàn)時(shí)，70%都到了中晚期，就是因?yàn)樗察o。

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如果她再拖半年，腫瘤可能穿透腸壁；如果沒(méi)查CEA，可能要等疼的直不起腰才來(lái)醫(yī)院——那時(shí)，5年生存率會(huì)從現(xiàn)在的90%，跌落到不足10%。

雖然腫瘤標(biāo)志物高，不一定是癌癥，但是這幾類(lèi)人，CEA高一點(diǎn)都別大意。

第一類(lèi)：40歲以上，尤其是50歲后

腸道黏膜的“老化”從40歲開(kāi)始加速，哪怕沒(méi)癥狀，也該像陳阿姨這樣，把腫瘤標(biāo)志物和胃腸鏡納入常規(guī)體檢。

第二類(lèi)：家里有腸癌病人的

父母、兄弟姐妹或子女得過(guò)結(jié)腸癌，風(fēng)險(xiǎn)比常人高3倍，見(jiàn)過(guò)最年輕的病例，28歲，因?yàn)閶寢尯凸霉枚际悄c癌，查腸鏡時(shí)發(fā)現(xiàn)了早期癌。

第三類(lèi)：有腸道息肉的

腺瘤性息肉是腸癌的“前身”，就算切了，也可能復(fù)發(fā)。陳阿姨同病房的大叔，5年前切過(guò)息肉沒(méi)復(fù)查，這次查出來(lái)癌已經(jīng)轉(zhuǎn)移了。

第四類(lèi)：管不住嘴、邁不開(kāi)腿的

長(zhǎng)期吃紅肉、香腸培根這類(lèi)加工肉，又不愛(ài)吃蔬菜，久坐不動(dòng)的人，腸道負(fù)擔(dān)重，黏膜容易出問(wèn)題。

其實(shí)CEA不是判決書(shū)，是提醒函！

（注：CEA正常參考值一般為0-5ng/ml，不同檢測(cè)機(jī)構(gòu)可能略有差異，輕度升高需結(jié)合臨床進(jìn)一步檢查，不能僅憑單一指標(biāo)判斷病情。）