Do elderly people with abnormal liver function need to undergo tumor biomarker testing?

Elderly people with abnormal liver function are usually recommended to undergo tumor biomarker testing, which can help identify potential diseases such as liver cancer and bile duct cancer. Abnormal liver function may be related to viral hepatitis, alcoholic liver disease, drug-induced liver injury, fatty liver, or tumor related diseases. Tumor markers such as alpha fetoprotein and carcinoembryonic antigen can serve as auxiliary diagnostic criteria.

When liver function abnormalities are combined with the following situations, tumor marker examination should be given special consideration. Long term chronic hepatitis B or hepatitis C virus infection may increase the risk of liver cancer, and the increase of alpha fetoprotein level is closely related to hepatocellular carcinoma. Bilirubin and alkaline phosphatase levels are significantly elevated, and caution should be exercised for cholangiocarcinoma. At this time, carcinoembryonic antigen and carbohydrate antigen 199 may be abnormal. When imaging reveals liver space occupying lesions, tumor markers can help differentiate between benign and malignant. Monitoring tumor markers can help detect metastatic lesions early in elderly individuals with a family history of malignant tumors or a history of cancer. Some non tumor diseases such as active cirrhosis may also lead to mild elevation of biomarkers, which needs to be comprehensively judged based on clinical manifestations. For liver function abnormalities with mild elevation of transaminase and no high-risk factors, virology and metabolic factor screening can be improved first. Simple fatty liver or drug-induced liver injury is usually not accompanied by elevated tumor markers, and excessive examination may increase economic burden. When elderly individuals are found to have mild elevated levels of isolated biomarkers during physical examinations, laboratory errors and inflammatory interference should be ruled out, and there is no need for excessive anxiety. Partial benign liver and gallbladder diseases such as liver abscess and bile duct stones may also cause transient elevation of related biomarkers.

It is recommended that elderly people choose examination items based on the degree, duration, and accompanying symptoms of liver function abnormalities under the guidance of a doctor. Daily alcohol consumption should be avoided, hepatotoxic drugs should be used with caution, and liver function indicators should be monitored regularly. If tumor markers remain abnormal or gradually increase, timely imaging examinations such as abdominal ultrasound and CT should be performed to confirm the diagnosis.