Laboratory Results & Preventive Examination

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Laboratory Results & Preventive Examination
Laboratory Results & Preventive Examination

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Video: Lab Results, Values, and Interpretation (CBC, BMP, CMP, LFT) 2023, January
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Laboratory results & preventive examination

Laboratory values ​​can provide important information about diseases or risk factors. On the one hand, laboratory values ​​help to confirm a suspected diagnosis made by the doctor.

On the other hand, with the help of laboratory values, the presence of a certain disease can also be excluded in many cases, for example if the patient concerned has normal laboratory findings. In medicine, this is referred to as so-called laboratory diagnostic "screening", whereby the term "screening" refers to the quality of an examination method to determine a correct result with high reliability. In the context of preventive examinations, laboratory values ​​generally represent an easy-to-use diagnostic instrument with high cost-efficiency.

Blood, urine and stool are primarily used as examination materials. But the so-called "Pap smear" is also extremely important with regard to cancer prevention.

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  • Precautionary goals - when laboratory values ​​make sense
  • How often should laboratory values ​​be collected?
  • ">Which laboratory values ​​are examined?

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  • Be careful with the term “tumor marker”!
  • Laboratory findings and disease prevention in particular

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In general, laboratory values ​​help in the early detection of a large number of diseases such as cardiovascular, metabolic (e.g. diabetes mellitus) and cancer. Furthermore, laboratory values ​​can provide indications of a risky lifestyle or health hazard.

Precautionary goals - when laboratory values ​​make sense

Laboratory values ​​can provide valuable information about frequent illnesses or risk constellations. However, the laboratory values ​​are only part of the overall preventive program. Accordingly, laboratory values ​​outside the respective reference range must be discussed in detail with the attending physician.

With these preventive care goals, laboratory values ​​provide important information for doctors and patients:

  • Prevention of cardiovascular diseases,
  • Diagnosis and prevention of metabolic diseases (e.g. diabetes),
  • Prevention of (alcohol-related) liver diseases,
  • Early detection of cancer.

How often should laboratory values ​​be collected?

The frequency for checking laboratory values ​​during the preventive examination is recommended as follows:

  • Between the ages of 18 and 40:

    Check every three years,

  • From the age of 40:

    Check every two years,

  • From the age of 50:

    • Immunocytochemistry: In individual tumor cells (in smears, punctures, etc.), tumor markers can be detected on the cell surface or in the cell nucleus by staining,
    • Immunohistochemistry: Detection of tumor markers on or within tumor cells in the tissue structure.

Which laboratory values ​​are examined?

There are a number of laboratory tests that can provide important information for making a diagnosis. A blood draw is quick and easy to perform. However, it should be noted that important rules of so-called preanalytics must be observed - e.g.:

  • Confirmation of diagnosis (confirmation of the tumor type),
  • Follow-up (does the disease progress, does it stay the same or does it improve?),
  • Detection of a relapse (eg recurrence of the tumor after primarily successful treatment).

The following laboratory values ​​are carried out as standard during the preventive examination:

Blood sugar determination: With regard to the presence of diabetes (diabetes mellitus)

  • Blood fats (triglycerides, total cholesterol, HDL and LDL cholesterol): In terms of the risk of cardiovascular disease.
  • Gamma-GT: With regard to the presence of alcohol-related liver disease.
  • Pap smear (for women): The pap smear is important in terms of early detection of cervical cancer.
  • PSA examination (for men): This is only carried out at the express request of the patient after adequate information from the attending physician.

Be careful with the term “tumor marker”

In laboratory medicine, the term “tumor marker” is a misleading and problematic term both for patients and for many specialists (read: doctors).

The reason for this is the fact that practically all tumor markers can also be elevated in some benign diseases:

  • in case of inflammation (e.g. pneumonia),
  • with infections (e.g. urinary tract infection),
  • after injuries, operations, examinations etc. (e.g. after a prostate examination).

A precise step-by-step plan must always be followed in cancer screening or cancer diagnostics.

Stage 1: indication for cancer diagnostics

  • Preventive medical check-up: e.g. PAP test for cervical cancer or colonoscopy for colon cancer.
  • Further clarification of a conspicuous previous finding: e.g. shadowing in the lung x-ray or suspicious lymph node swelling, etc.

Stage 2: Morphological tumor diagnosis

  • Microscopic detection of cancer cells (cytology),
  • microscopic evidence of cancerous tissue (histology.

Stage 3: Determination of tumor markers (cell tumor markers, tissue tumor markers, blood tumor markers)

  • Detection of tumor markers on cells and tissue using special staining techniques:

    • Immunocytochemistry: With individual tumor cells (in smears, punctures, etc.), tumor markers can be detected on the cell surface or in the cell nucleus by staining.
    • Immunohistochemistry: Detection of tumor markers on or within tumor cells in the tissue structure.
  • Detection of tumor markers in the blood ("blood tumor markers") only makes sense after level two has been completed. These "laboratory tumor markers" help with:

    • Confirmation of diagnosis (confirmation of the tumor type),
    • Follow-up (does the disease progress, does it remain the same or does it improve?).
    • Detection of a relapse (eg recurrence of the tumor after primarily successful treatment).

In this step-by-step plan for the prevention or clarification of a suspected cancer, the individual steps one to three are always to be taken exactly as with stairs - namely one after the other.

Laboratory findings and disease prevention in particular

A number of laboratory tests for cardiovascular, metabolic and cancer diseases are recommended for screening. These examinations help to discover risk factors and diseases at an early stage.

Heart and circulatory diseases

In the laboratory tests with regard to the prevention of cardiovascular diseases (angina pectoris, heart attack, stroke, etc.), the early detection of lipid metabolic disorders has the highest priority. The following laboratory values ​​(blood lipids) are collected for this purpose:

  • Triglyceride determination (fasting blood sample!),
  • Cholesterol determination:

    • Total cholesterol,
    • HDL and LDL cholesterol,
    • Ratio of total cholesterol to HDL cholesterol.

The connection between lipid metabolism disorders (increase in blood lipids) and the clinical manifestation of arteriosclerosis (vascular calcification) is considered medically proven.

Other risk factors for cardiovascular diseases in addition to increased blood lipids are:

  • Overweight,
  • Sedentary lifestyle,
  • Smoke,
  • High blood pressure (hypertension)
  • Diabetes (diabetes mellitus) and
  • Gout.

Diabetes mellitus

In the prevention of diabetes mellitus, the determination of the personal risk is a top priority.

The preventive medical check-up takes place in two phases:

  • Blood sugar measurement from capillary blood from the fingertip or from venous blood.

    Blood sugar limits: not fasting (200 mg / dl), fasting (126 mg / dl); Anyone who has not eaten or smoked for eight to 14 hours before the measurement is considered sober

  • The HbA1C value is not required for screening.

Confirmation of diagnosis when blood sugar limits are exceeded:

The diagnosis of diabetes mellitus is made regardless of age and gender by measuring multiple increased fasting blood sugar levels on at least two different days

If the clinical picture is suspicious and the measurement results are contradicting, the diagnosis can also be made using an oral glucose tolerance test.

Note Determination using a test strip is not suitable for making a diagnosis.

Detailed information on diabetes mellitus.

Liver disease (alcoholism)

Chronic alcohol abuse is the leading cause of liver disease. The toxic (liver damaging) limit for alcohol consumption is over a longer period of time (months to years)

  • for women at 20 grams per day and
  • for men at 40 grams per day.

Note Half a liter of beer (a mug) contains 20 grams of alcohol.

The alcohol-toxic liver damage progresses in three stages:

  • pure fatty liver,
  • alcoholic fatty liver hepatitis,
  • Cirrhosis of the liver.

For the stage of pure fatty liver, the determination of the gamma GT is useful. This laboratory value is unspecific. For some patients, however, the determination of the gamma GT can make it easier to deal with the problem of alcohol consumption in the doctor-patient conversation.

Detailed information on:

  • Liver disease as well
  • Alcohol addiction.

Cancers

The following laboratory tests are very important for cancer screening:

Annual screening for occult blood in stool from the age of 50 to prevent colon / rectum cancer. This test can be carried out at home or at the doctor's office.

Pap smear for the early detection of cervical cancer. Screening for cervical cancer is recommended for all women over the age of 18:

  • under 40 every three years,
  • over 40 every two years.

The smear is carried out by gynecologists and the material is sent to a cytological laboratory.

Prostate cancer screening:

  • The systematic routine screening for the early detection of prostate cancer by means of digital rectal examination and / or with the help of tumor markers in the blood (PSA) is currently not recommended on the basis of the state of international medical knowledge.
  • All over the world, all the facts that have become known to date speak against mass screening for all men over 50 years of age in prostate cancer early detection.
  • Men over 50 who, after being informed by the doctor, wish to have a PSA test during the preventive medical check-up should be referred to a specialist in urology at their express request.

Detailed information on cancer.

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