Test Results: Concerns About Tumor Risk and Further Examinations - Internal Medicine

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Please inquire about the test results?


Hello, doctor.
Recently, my father experienced swelling in his throat and left hand due to stress, prompting him to visit a rheumatology and immunology specialist.
Based on his condition, the doctor ordered the following tests (the items listed are from the National Health Insurance Quick Inquiry, and I did not see the hospital's test report):
- P-ANCA (Anti-MPO): <0.20
- Hemoglobin: 13.8
- MCH: 30.0
- MCHC: 32.3
- MCV: 92.8
- MPV: 7.90
- PDW: 8.1
- Platelet: 337
- RBC: 4.60
- RDW-CV: 13.2
- WBC: 4.68
- Basophil: 0.9
- Eosinophil: 3.0
- Lymphocyte: 44.7
- Monocyte: 6.6
- Neutrophil: 44.8
- Blood Urea Nitrogen: 19
- Fasting Blood Glucose: 105
- Uric Acid: 4.5
- Creatinine: 0.78
- eGFR (MDRD): >60
- Sodium: 137
- Potassium: 4.1
- Serum Glutamate Pyruvate Transaminase: 14
- Serum Glutamate Oxaloacetate Transaminase: 14
- Lactate Dehydrogenase: 153
- Free Thyroxine Immunoassay: 1.18
- Thyroid Stimulating Hormone Immunoassay: 0.681
- An: 86
- RPR: Non-reactive
- RF: <10.0
- CRP: 0.098
- IgG: 877.2
- IgA: 140.0
- IgM: 79.99
- IgE: 138.0 (Reference value: 0.0-100.0, no red flags shown)
- C3: 111.2
- C4: 28.2
- ANA: Negative
- ANA pattern: Punctate nucleolar (AC-10) (Reference value: Negative, no red flags shown)
- Anti-dsDNA: 1.10
- Anti-La Ab: 8
- Anti-Ro Ab: 5
- C-ANCA (Anti-PR3): <0.20
- Anti-RNP: 15
- Anti-Sm Ab: 5
- Anti-cop Ab: 1.1
- HBs Ag: 0.31
- Anti-HBs: >1000.0 (Reference value: 0-10.0, no red flags shown)
- Anti-HBc: 0.008 (Reference value: >1000, no red flags shown)
- Anti-HCV: 0.035
- Erythrocyte Sedimentation Rate (1 hour): 9
- Hematocrit: 42.7
After the tests, my father had a follow-up appointment two weeks later.
According to his account, the doctor indicated that my father has elevated tumor markers and a high risk of allergies, qualifying him for further detailed examinations, leading to a three-day hospitalization for comprehensive testing.
This information has shocked our entire family.
I would like to ask the doctor:
1.
The attending physician did not inform us where the tumor is located, nor did they explain which specific values were concerning for this assessment.
Could you please clarify which values indicate a problem and whether there is a high risk of cancer?
2.
What specific examinations will be conducted during the physical check-up? I found that a complete health check-up online typically takes no more than two days; what kind of extensive testing would require three days?
Thank you again for taking the time to assist with these questions.

A Yi, 20~29 year old female. Ask Date: 2024/04/25

Dr. Gao Jiankai reply Internal Medicine


Hello, thank you for your inquiry.
Here are my responses:
1.
The attending physician did not inform us about the location of the tumor, nor did they provide a detailed explanation to my father regarding which specific values were problematic for the diagnosis.
Could you please clarify what the issues are and whether there is a high risk of cancer? --> Based on the test results you provided, I do not see any tumor markers.
2.
What specific tests are typically included in a health examination? I found that a comprehensive health check can usually be completed within two days, so what could possibly require three days for a physical examination? --> There are numerous health check items and options, so I cannot specify which tests you might undergo or how long the examination will take.
I believe if you have concerns, it would be best to discuss them with your father's physician without rushing into hospitalization.
The decision regarding hospitalization lies with your father and his family.

Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2024/04/25

More Info


Dear Patient,
Thank you for reaching out with your concerns regarding your father's recent health evaluations and the subsequent recommendations for further testing. I understand that receiving such news can be overwhelming, and I will do my best to clarify the situation based on the information provided.

1. Understanding Tumor Risk Indicators: The laboratory results you shared indicate a range of blood tests, including markers that can suggest inflammation, immune response, and potential autoimmune conditions. The specific mention of "tumor markers" and "high allergy risk" by the physician may relate to several factors in the test results. For example, elevated levels of certain immunoglobulins (like IgE) can indicate allergic reactions, while other markers may suggest an inflammatory process. However, the results you provided do not explicitly indicate the presence of cancer or a specific tumor.
The physician's conclusion about a "tumor index" could be based on the overall clinical picture, including symptoms your father is experiencing (such as swelling in the throat and left hand) and the laboratory findings. It's important to note that many benign conditions can also lead to elevated markers, and further diagnostic imaging or biopsies may be necessary to determine the exact nature of any potential tumors.

2. Further Examination Procedures: Regarding the follow-up examinations, the specific tests performed during a hospital stay can vary widely based on the initial findings and the physician's clinical judgment. Typically, a comprehensive evaluation may include:
- Imaging Studies: This could involve CT scans, MRIs, or ultrasounds to visualize internal structures and identify any abnormalities.

- Biopsies: If any suspicious masses or lesions are identified, a biopsy may be performed to obtain tissue samples for histological examination.

- Additional Blood Tests: These may include more specific tumor markers, complete blood counts, and metabolic panels to assess organ function and overall health.

- Consultations with Specialists: Depending on the findings, your father may be referred to oncologists, hematologists, or other specialists for further evaluation.

The duration of three days for a thorough examination may seem extensive, but it allows for comprehensive testing, observation, and the possibility of multiple consultations. Each test requires time for preparation, execution, and analysis, and the healthcare team may want to monitor your father's condition closely during this period.

In conclusion, while the initial results may raise concerns, it is essential to await the outcomes of the detailed examinations to gain a clearer understanding of your father's health status. I recommend maintaining open communication with the healthcare team, asking for clarification on any specific results, and discussing the next steps in detail. This will help alleviate concerns and ensure that your father receives the appropriate care.

Thank you for your patience, and I wish your family the best during this challenging time. If you have any further questions or need additional clarification, please do not hesitate to ask.

Best regards.

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