لطالما كان حلم الطب هو الوصول إلى تحليل دم بسيط يخبرنا بوجود السرطان قبل نموه. ورغم أننا لم نصل بعد إلى تحليل “سحري” واحد، إلا أن دلالات الأورام هي أدوات قوية جداً يستخدمها الأطباء بحذر ودقة لمراقبة المعركة داخل الجسم.
1. ما هي دلالات الأورام؟
هي مواد (غالباً بروتينات) تنتجها الخلايا السرطانية أو تنتجها خلايا الجسم الطبيعية استجابةً لووجود السرطان. تفرز هذه المواد في الدم، البول، أو الأنسجة، ويمكن قياسها في المختبر.
2. أشهر أنواع دلالات الأورام واستخداماتها:
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PSA (مستضد البروستاتا النوعي): يستخدم للكشف عن مشاكل البروستاتا لدى الرجال.
-
CA-125: يُطلب غالباً لمتابعة حالات سرطان المبيض.
-
CEA (المستضد الجنيني السرطاني): يستخدم بشكل أساسي لمتابعة سرطان القولون والجهاز الهضمي.
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AFP (ألفا فيتو بروتين): يساعد في تشخيص أورام الكبد وسرطان الخصية.
3. الحقيقة المهمة: لماذا لا تعتبر تشخيصاً نهائياً؟
هناك مفهوم خاطئ بأن ارتفاع الدلالة يعني “سرطان” حتماً. والحقيقة هي:
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الإيجابية الكاذبة: قد يرتفع مستوى الدلالات بسبب التهابات عادية أو تضخم حميد (مثلاً، يرتفع الـ PSA عند التهاب البروستاتا البسيط).
-
السلبية الكاذبة: في بعض الأحيان، يكون السرطان موجوداً لكن الخلايا لا تفرز هذه البروتينات بنسبة عالية تظهر في الفحص.
4. إذن، ما هي الفائدة الحقيقية منها؟
تتجلى قوة هذه التحاليل في “المتابعة” وليس “المسح الشامل”:
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مراقبة العلاج: إذا كان مريض السرطان يخضع لعلاج كيميائي، فإن انخفاض مستويات الدلالة في التحاليل الدورية يعني أن العلاج ينجح في قتل الخلايا السرطانية.
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التنبؤ بالانتكاسة: هي “جهاز إنذار مبكر”، حيث يبدأ المستوى بالارتفاع مجدداً قبل ظهور الورم بالأشعة بفترة طويلة، مما يسمح بالتدخل السريع.


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