Usually, patients think about primary tests when certain symptoms come to them, the disease does not go away for a long time, or the general condition of the body worsens. Then the doctor, in any case, first of all sends the patient to take tests, after which it is already possible to say whether cancer is possible or not. We will try to explain to you as briefly and clearly as possible about each blood test for oncology.
Can blood test detect cancer?
Unfortunately, a blood test for cancer does not allow 100% to see cancer cells, but there is a certain degree of probability to identify a diseased organ. Blood is exactly the liquid that interacts with all tissues and cells in the human body, and it is understandable that by a change in the chemical or biochemical composition, one can determine what is wrong with a person.
The analysis gives a signal to the doctor that the processes in the body are not proceeding correctly. And then he sends the patient for additional diagnostics of certain organs. By blood, it is possible to identify in which organ the tumor can live, at what stage and what size. True, if a person additionally suffers from any diseases, then the accuracy of this study will be lower.
What blood tests show cancer?
- General (clinical)- shows the total number of red blood cells, platelets, white blood cells and other cells in the blood. Deviations from the general indicator may also indicate a malignant tumor.
- Biochemistry - usually shows the chemical composition of the blood. This analysis can more accurately determine in which place and in which organ a person develops cancer.
- Analysis for tumor markers- one of the most accurate analyzes for oncologists. When a tumor develops in the body and cells in a certain place begin to mutate, then this thing itself releases certain proteins or tumor markers into the blood. For the body, this protein is foreign, which is why the immune system immediately begins to try to fight it. Tumor markers for each of the tumors are different and they can be used to determine in which organ the enemy has settled.
Complete blood count and cancer
About the benefits of analysis
The human body is a very complex mechanism in which each individual system works in conjunction with the rest. Thus, any, even at first glance, a minor violation leads to negative consequences in the long term.
Since the blood circulates throughout the body, its formula is affected by any inflammatory process.
The production of hormones is also centrally regulated. Therefore, a decrease in the volume of one substance often leads to an imbalance of the entire system. Quantitative indicators help doctors make an accurate prediction based on test results.
At the same time, urine, passing through the filtration in the kidneys and being evacuated from the body through the genitals, provides very accurate data on their health.
In general, a general idea of \u200b\u200bwell-being - both an adult and a child - is not difficult to compile on the basis of just a few laboratory tests.
The advantages of this kind of research are obvious. They are:
- not too expensive;
- simple;
- do not affect health, even if they are carried out frequently.
If a person feels generally satisfactory, this does not mean that he does not have any health problems. Spare "capacity" of the body is quite enough to compensate for many violations formed due to pathologies.
In the absence of specific complaints, it is enough to come annually for preventive tests and you will never lose control over the situation. However, if you have unpleasant symptoms from the list below, you should not postpone a visit to the doctor even for a single day:
- various pains that have a clear localization and appear regularly;
- feeling of weakness;
- high irritability;
- a sharp weight gain;
- fast weight loss;
- long lasting infections.
The doctor will perform an examination and, on its basis, give directions for other examinations, but, first of all, send it to the laboratory.
What kind of tests are taken regularly
When there are no special complaints about well-being, you can limit yourself to only two samples. These are general analyzes:
- blood;
- urine.
This option is the cheapest and most straightforward, and it also allows you to bring out many dangerous ailments in the early stages with great accuracy.
A general blood test reveals the following parameters:
- amount of hemoglobin;
- the rate of sedimentation of platelets and erythrocytes;
- content of other components.
Based on the results of this test, the doctor is able to identify the presence of a problem and take all necessary measures to eliminate it.
A urinalysis is also very informative. In addition to the previously mentioned pathologies of the kidneys and the reproductive system, it also allows you to detect diabetes and some hematopoietic diseases.
In addition, it would be useful to take a sample for a lipid profile and cholesterol. Its frequency is as follows:
- at least once every five years - from 35 to 45;
- every 3 years - from 45 to 50;
- annually - after 50 years.
This analysis helps to detect problems with fat metabolism in a timely manner and signal the onset of atherosclerosis. And this, in turn, minimizes the risk:
- vascular thrombosis;
- stroke
- heart attack.
To date, the analysis of sugar is considered not very reliable. Instead, you should take a test that helps determine the amount of glycated hemoglobin. With its help, it is possible to find out how much the glucose indicator has fluctuated over the past 6-8 weeks.
It is carried out:
- from 30 to 40 - in five years;
- from 40 to 45 - every 2 years;
- later - at least once every 12 months.
- bilirubin;
- creatinine;
- total protein;
- urea.
With its help, it is possible to get an idea about the functioning of the metabolism in general and the kidneys with the liver in particular. The frequency of this procedure is once a year.
An analysis of thyroid-stimulating hormone (TSH) will tell about the health of the thyroid gland. The problem is that over the past few years, the number of cases of hypothyroidism has noticeably increased, and therefore the previously named study is recommended by doctors to be included in the list of planned activities.
Another very informative test is the level of homocysteine. It helps to detect the risk of blood clots in the vessels.
Do not forget about hepatitis (B and C) and AIDS. These infections have long been considered the most common on Earth. The danger is that they do not show themselves for many years. Such an analysis must also be taken annually.
How to prepare for analysis
The general rules are generally not too complicated. The patient is required to:
- do not eat at least 6 hours;
- spend a day without physical activity;
- avoid as many violent emotions and stresses;
- 2 days do not drink any alcohol;
- 3 hours no smoking.
All samples are taken in the morning. If the doctor gives a referral, then it indicates the exact time of the visit to the laboratory.
Women should also avoid physical intimacy before testing for sex hormones and inform the specialist about the phase of the menstrual cycle.
Update: December 2018
In modern oncology, early diagnosis of the tumor process plays a huge role. The further survival and quality of life of patients depends on this. Cancer alertness is very important, since cancer can manifest itself in the last stages or mask its symptoms under other diseases.
Groups at risk of developing malignant neoplasms
There are many theories of the development of cancer, but none of them gives a detailed answer, why does it still occur. Doctors can only assume that one or another factor accelerates carcinogenesis (growth of tumor cells).
Cancer risk factors:
- Racial and ethnic predisposition- German scientists have established a trend: melanoma occurs 5 times more often in white-skinned people than in blacks.
- Diet Violation- the human diet must be balanced, any shift in the ratio of proteins, fats and carbohydrates can lead to metabolic disorders, and as a result, to the occurrence of malignant neoplasms. For example, scientists have shown that excessive consumption of foods that increase cholesterol leads to the development of lung cancer, and excessive intake of easily digestible carbohydrates increases the risk of developing breast cancer. Also, the abundance of chemical additives in food (flavor enhancers, preservatives, nitrate, etc.), genetically modified foods increase the risk.
- Obesity - according to American studies, excess body weight increases the risk of cancer by 55% in women and 45% in men.
- Smoking - WHO doctors have proven that there is a direct causal relationship between smoking and cancer (lips, tongue, oropharynx, bronchi, lungs). In the UK, a study was conducted that showed that people who smoke 1.5-2 packs of cigarettes a day are 25 times more likely to develop lung cancer than non-smokers.
- Heredity– There are certain types of cancer that are inherited in an autosomal recessive and autosomal dominant manner, such as ovarian cancer or familial intestinal polyposis.
- Exposure to ionizing radiation and ultraviolet rays- ionizing radiation of natural and industrial origin causes the activation of thyroid cancer pro-oncogenes, and prolonged exposure to ultraviolet rays during insolation (sunburn) contributes to the development of malignant melanoma of the skin.
- immune disorders- a decrease in the activity of the immune system (primary and secondary immunodeficiencies, iatrogenic immunosuppression) leads to the development of tumor cells.
- Professional activity- this category includes people who, in the course of their work, come into contact with chemical carcinogens (resins, dyes, soot, heavy metals, aromatic carbohydrates, asbestos, sand) and electromagnetic radiation.
- Features of reproductive age in women- early first menstruation (under 14 years of age) and late menopause (over 55 years of age) increase the risk of breast and ovarian cancer by 5 times. At the same time, pregnancy and childbirth reduce the tendency for the appearance of neoplasms of the reproductive organs.
Symptoms that may be signs of cancer
- Long-term non-healing wounds, fistulas
- Discharge, ribbon-like feces. Violation of the functions of the bladder and intestines.
- Deformation of the mammary glands, the appearance of swelling of other parts of the body.
- Sudden weight loss, loss of appetite, difficulty swallowing.
- Changes in the color and shape of moles or birthmarks
- Frequent or unusual discharge in women.
- , not amenable to therapy, .
General principles for diagnosing malignant neoplasms
After contacting a doctor, the patient should receive full information about which tests indicate cancer. It is impossible to determine oncology by a blood test, it is nonspecific in relation to neoplasms. Clinical and biochemical studies are aimed primarily at determining the patient's condition with tumor intoxication and studying the functioning of organs and systems.
A general blood test for oncology reveals:
- leukopenia or (increased or decreased white blood cells)
- shift of the leukocyte formula to the left
- anemia ()
- (low platelets)
- (constantly high ESR more than 30 in the absence of serious complaints - a reason to sound the alarm)
A general urinalysis in oncology can be quite informative, for example, in multiple myeloma, a specific Bens-Jones protein is detected in the urine. A biochemical blood test allows you to judge the state of the urinary system, liver and protein metabolism.
Changes in biochemical analysis indicators for various neoplasms:
| Indicator | Result | Note |
it is possible to both increase and decrease |
Neoplasms usually enhance catabolic processes and protein breakdown, non-specifically inhibit protein synthesis. | |
| hyperproteinemia, hypoalbuminemia, detection of paraprotein (M-gradient) in serum | Such indicators make it possible to suspect multiple myeloma (malignant plasmacytoma). | |
| Urea, creatinine |
Increase in urea and creatinine levels |
This indicates an increased protein breakdown, an indirect sign of cancerous intoxication, or a nonspecific decrease in kidney function. |
| Increase in urea with normal creatinine | Indicates the decay of tumor tissue. | |
| Alkaline phosphatase |
An increase in alkaline phosphatase over 270 U / l |
Speaks about the presence of metastases in the liver, bone tissue, osteogenic sarcoma. |
| An increase in the enzyme against the background of normal indicators of AST and ALT | Also, embryonic tumors of the ovaries, uterus, testicles can ectopic placental ALP isoenzyme. | |
| ALT, AST |
An increase in enzymes above the upper limit of normal |
It indicates a non-specific breakdown of liver cells (hepatocytes), which can be caused by both an inflammatory and a cancerous process. |
| Cholesterol |
The decrease in the indicator is less than the lower limit of the norm |
Talks about malignant neoplasms of the liver (since cholesterol is formed in the liver) |
| Potassium |
An increase in the electrolyte level at a normal level of Na |
Evidence of cancer cachexia |
A blood test for oncology also provides for the study of the hemostasis system. Due to the release of tumor cells and their fragments into the blood, it is possible to increase blood clotting (hypercoagulation) and microthrombosis, which impede the movement of blood along the vascular bed.
In addition to tests to determine cancer, there are a number of instrumental studies that contribute to the diagnosis of malignant neoplasms:
- Plain radiography in direct and lateral projection
- Contrast radiography (irrigography, hysterosalpingography)
- Computed tomography (with and without contrast)
- Magnetic resonance imaging (with and without contrast)
- Radionuclide method
- Doppler ultrasound
- Endoscopic examination (fibrogastroscopy, bronchoscopy).
Stomach cancer
Stomach cancer is the second most common tumor in the population (after lung cancer).
- Fibroesophagastroduodenoscopy is the golden method for diagnosing gastric cancer, it is necessarily accompanied by a large number of biopsies in different areas of the neoplasm and unchanged gastric mucosa.
- Radiography of the stomach using oral contrast (barium mixture) - the method was quite popular before the introduction of endoscopes into practice, it allows you to see a filling defect in the stomach on the radiograph.
- Ultrasound examination of the abdominal organs, CT, MRI - are used to search for metastases in the lymph nodes and other organs of the digestive system (liver, spleen).
- Immunological blood test - shows stomach cancer in the early stages, when the tumor itself is not yet visible to the human eye (CA 72-4, CEA and others)
Diagnosis of colon cancer
- Finger examination of the rectum - detects cancer at a distance of 9-11 cm from the anus, allows you to assess the mobility of the tumor, its elasticity, the state of neighboring tissues;
- Colonoscopy - the introduction of a video endoscope into the rectum - visualizes the cancerous infiltrate up to the Bauhinian damper, allows biopsy of suspicious areas of the intestine;
- Irrigoscopy - X-ray of the large intestine using double contrast (contrast-air);
- Ultrasound of the pelvic organs, CT, MRI, virtual colonoscopy - visualize the germination of colon cancer and the state of adjacent organs;
- Determination of tumor markers - CEA, C 19-9, Sialosyl - TN
Mammary cancer
This malignant tumor occupies a leading place among female neoplasms. Such disappointing statistics are to some extent due to the low qualification of doctors who conduct an unprofessional examination of the mammary glands.
- Palpation of the gland - allows you to determine the tuberosity and swelling in the thickness of the organ and suspect the tumor process.
- Breast X-ray (mammography) is one of the most important methods for detecting non-palpable tumors. For greater information content, artificial contrasting is used:
- pneumocystography (withdrawal of fluid from the tumor and the introduction of air into it) - allows you to identify parietal formations;
- ductography - the method is based on the introduction of a contrast agent into the milk ducts; visualizes the structure and contours of the ducts, and abnormal formations in them.
- Sonography and Dopplerography of the mammary glands - the results of clinical studies have proven the high efficiency of this method in the detection of microscopic intraductal cancer and abundantly supplied neoplasms.
- Computed and magnetic resonance imaging - allow you to assess the germination of breast cancer in nearby organs, the presence of metastases and damage to regional lymph nodes.
- Immunological tests for breast cancer (tumor markers) - CA-15-3, cancer embryonic antigen (CEA), CA-72-4, prolactin, estradiol, TPS.
thyroid cancer
Due to the increase in radiation and exposure of people over the past 30 years, the incidence of thyroid cancer has increased by 1.5 times. Basic diagnostic methods:
- Ultrasound + dopplerography of the thyroid gland is a rather informative method, non-invasive and does not carry radiation exposure.
- Computed and magnetic resonance imaging are used to diagnose the spread of the tumor process beyond the thyroid gland and to detect metastases to neighboring organs.
- Positron emission tomography is a three-dimensional technique, the use of which is based on the property of a radioisotope to accumulate in the tissues of the thyroid gland.
- Radioisotope scintigraphy is a method also based on the ability of radionuclides (more precisely, iodine) to accumulate in the tissues of the gland, but unlike tomography, it indicates the difference in the accumulation of radioactive iodine in healthy and tumor tissue. Cancer infiltrate may look like a "cold" (not absorbing iodine) and "hot" (absorbing iodine in excess) focus.
- Fine-needle aspiration biopsy - allows for a biopsy and subsequent cytological examination of cancer cells, reveals special genetic markers hTERT, EMC1, TMPRSS4 of thyroid cancer.
- Determination of the protein galectin-3, belonging to the class of lectins. This peptide is involved in the growth and development of tumor vessels, its metastasis, and suppression of the immune system (including apoptosis). The diagnostic accuracy of this marker in malignant neoplasms of the thyroid gland is 92-95%.
- Thyroid cancer recurrence is characterized by a decrease in thyroglobulin levels and an increase in the concentration of oncomarkers EGFR, HBME-1
Esophageal carcinoma
The cancer mainly affects the lower third of the esophagus and is usually preceded by intestinal metaplasia and dysplasia. The average incidence is 3.0% per 10,000 population.
- X-ray contrast examination of the esophagus and stomach using barium sulfate is recommended to clarify the degree of esophageal patency.
- Fibroesophagogastroduodenoscopy - allows you to see cancer with your own eyes, and an improved videoscopic technique displays the image of esophageal cancer on a large screen. During the study, a biopsy of the neoplasm is mandatory, followed by cytological diagnosis.
- Computed and magnetic resonance imaging - visualize the degree of tumor germination in neighboring organs, determine the state of regional groups of lymph nodes.
- Fibrobronchoscopy - is necessarily performed when cancer of the esophagus compresses the tracheobronchial tree and allows you to assess the degree of diameter of the airways.
Oncomarkers - immunological diagnostics of neoplasms
The essence of immunological diagnostics is the detection of specific tumor antigens or tumor markers. They are quite specific for specific types of cancer. A blood test for tumor markers for primary diagnosis has no practical application, but it allows you to determine the early occurrence of recurrence and prevent the spread of cancer. There are more than 200 types of cancer markers in the world, but only about 30 have diagnostic value.
Doctors have the following requirements for oncomarkers:
- Must be highly sensitive and specific
- The tumor marker must be secreted only by malignant tumor cells, and not by the body's own cells.
- Tumor marker must point to one specific tumor
- Blood test values for tumor markers should increase as cancer progresses
Classification of tumor markers
All tumor markers: click to enlarge
According to the biochemical structure:
- Oncofetal and oncoplacental (REA, HCG, alpha-fetoprotein)
- Tumor-associated glycoproteins (CA 125, CA 19-9. CA 15-3)
- Keratoproteins (UBC, SCC, TPA, TPS)
- Enzymatic proteins (PSA, neuron-specific enolase)
- Hormones (calcitonin)
- Other structure (ferritin, IL-10)
By value for the diagnostic process:
- The main one is characterized by maximum sensitivity and specificity for a particular tumor.
- Secondary - has little specificity and sensitivity, is used in combination with the main oncomarker.
- Additional - detected with a variety of neoplasms.
| cancer marker | The rate of the indicator | The neoplasm in which it is detected |
| Bence Jones protein | norm - absent | Myeloma (malignant plasmacytoma), B-cell leukemia |
| Alpha fetoprotein | norm - less than 22 ng / ml | Hepatocellular carcinoma, germinal cancers (cancer of the ovaries, testicles, and others) |
| Cancer embryonic antigen (CEA) | less than 5 U/ml | Colorectal tumors (colon cancer), breast cancer, lung cancer |
| SA-125 | less than 30 U/ml | ovarian cancer |
| Prostate specific antigen (PSA) | less than 5 ng/ml | |
| Chorionic gonadotropin (CG) | ||
| NSE - neuron-specific enolase | 12 ng/ml | Small cell lung cancer, neuroendocrine tumors |
| CYFRA 21-1 | less than 2 ng/ml | |
| Calcitonin | 0-30 pg/ml |
Annual medical examination is an integral part of monitoring your own health. This event involves the delivery of certain tests and the passage of diagnostic studies that will allow in the early stages to determine even asymptomatic diseases.
If a disease is detected in a timely manner, it can be dealt with quite quickly and inexpensively, which cannot be said about neglected pathologies, when a patient comes to the doctor with serious symptoms.
Top Mandatory Annual Tests
To control your own health, experts advise to take the following tests every year:
- Material for research is taken from the finger. The analysis shows the presence or absence of blood diseases, anemia, inflammatory processes. Based on the data obtained, an experienced doctor can draw a conclusion about the state of the human immune system.
- . This is the main study to assess the condition of the genitourinary system. The presence of leukocytes in the urine will indicate inflammation, while the level of this indicator can determine which organ was affected and suggest the development of cystitis, urethritis, pyelonephritis and other diseases. In addition, a urine test can indicate the development of diabetes.
- Blood chemistry. For the study, blood is taken from a vein. Having studied the results of this analysis, a specialist can evaluate the work of many organs and systems of the body: kidneys, liver, bile ducts. Biochemistry well reflects the well-established metabolic processes in the body - one of the main indicators of good health.
- Blood test for glycated hemoglobin is needed to assess the level of sugar in the blood and its fluctuations over the past 4-6 weeks.
- Analysis for STIs: ureaplasmosis, trichomoniasis, mycoplasmosis and others.
- Thyroid hormone analysis. For research, blood is taken from a vein and the levels of free thyroxine and thyroid-stimulating hormone are determined. Such a diagnosis is especially important for residents of large cities, where there is a pronounced natural iodine deficiency.
In addition, the annual medical examination involves the passage of the following studies and examinations by specialists:
- electrocardiogram - a highly informative method for studying the work of the heart;
- fluorography - in the early stages allows you to suspect diseases and tumors of the tissues covering the lungs;
- for women - examination by a gynecologist, for men - by a urologist;
- an annual examination by an ophthalmologist will prevent the development of glaucoma and cataracts;
- Sanitation of the oral cavity at the dentist will allow you to keep your teeth healthy for as long as possible.
What else you need to check after 45 years
At this age, the risk of developing various diseases increases, so doctors recommend undergoing an annual medical examination, which involves passing additional tests and passing highly informative studies:
- Annually it is necessary to do an analysis for tumor markers: men are prescribed a test for a tumor marker of the prostate, rectum and large intestine, women - for a tumor marker of the mammary glands, ovaries, as well as the rectum and large intestine.
- Women should be tested for sex hormones and C-peptide.
- Colonoscopy - examination of the colon.
- Gastroscopy allows you to identify in the early stages of the pathology of the stomach, esophagus and duodenum.
- A blood test to determine the lipid profile and cholesterol levels in particular. The main goal of such a study is the timely detection of atherosclerotic changes in the vessels. With it, you can prevent the occurrence of vascular thrombosis, sudden stroke or heart attack.
Mandatory annual tests for women
The female body is designed in such a way that many serious gynecological diseases in the early stages are completely asymptomatic. For this reason, women are recommended not only to visit a gynecologist every year, but also to take a number of mandatory tests:
- smear on flora: a study showing the quantitative and qualitative composition of the microflora of the vagina, cervix and urethra. It is the main technique that detects the presence of pathogenic agents in the scraping of the surface of these areas. It is the deviations in the smear on the flora that serve as the basis for the appointment of additional high-precision analyzes.
- Bakposev determines the presence and type of causative agent of a bacterial infection. In addition, the analysis shows to which antibacterial substance the pathogenic agent found in the analysis is sensitive.
- detects the presence of STIs: ureaplasmosis, genital herpes, chlamydia and others.
- Blood test for TORCH infection allows you to determine antibodies to the rubella virus, cytomegalovirus, toxoplasmosis and herpes simplex virus.
The state of health in the future largely depends on what measures a person takes to preserve it today. Therefore, you should not ignore the recommendations of doctors, but on your own initiative, undergo a full range of diagnostic studies that describe a complete picture of the coordinated work of all organs and systems of the body.
The introduction of this contraceptive is carried out in the last days of the menstrual cycle or in the first days after it. After an abortion or childbirth without complications, the procedure is carried out immediately after the operation or after 5-6 weeks. After a cesarean section, a spiral can be installed only after 10-12 weeks.
As a rule, the installation is carried out without anesthesia. Of course, each type of spiral has its own characteristics, introduction, but the basic principle is the same. The woman is located on the gynecological chair, the external genital organs are treated with an antiseptic agent, and then the cervix. After that, the neck is fixed on bullet forceps and it is straightened. A conductor with a closed contraceptive is inserted into the cervical canal and moves into the uterine cavity to the required distance. Then, by the movement of the piston, the spiral opens and is located inside. Threads - antennae are placed in the vagina and cut to the desired length. The procedure is almost painless and takes about 5-7 minutes.
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General blood analysis is a widely used laboratory test that allows you to establish and suspect a large number of pathologies, as well as monitor a person's condition in chronic pathologies or against the background of ongoing therapy. In a word, a complete blood count is both a universal and non-specific test, since its results can be correctly deciphered and interpreted only in connection with a person's clinical symptoms.General blood test - characteristic
Complete blood count is now correctly called clinical blood test. However, doctors, laboratory staff, and patients in everyday life still use the old and familiar term "general blood test" or, in short, KLA. Everyone is used to the old term and understands what it means, therefore, various changes in terminology are simply not perceived by either doctors or patients, and therefore the name CBC continues to reign in everyday life. In the following text, we will also use the everyday term familiar to everyone, and not the new correct name, so as not to confuse anyone and not cause confusion.Currently, complete blood count is a routine method. laboratory diagnostics a wide range of different pathologies. This analysis is used both to confirm a suspected disease, and to identify hidden pathologies that do not manifest symptoms, and for preventive examinations, and to monitor a person’s condition during treatment or a chronic course of an incurable disease, etc., as it provides a wide range of information about the state of the blood system and the body as a whole. Such universality of the general blood test is explained by the fact that during its implementation various blood parameters are determined, which are influenced by the state of all organs and tissues of the human body. And, therefore, any pathological changes in the body are reflected in varying degrees of severity on the parameters of the blood, because it reaches literally every cell of our body.
But such universality of the general blood test has a downside - it is non-specific. That is, changes in each parameter of the general blood test may indicate various pathologies from different organs and systems. The doctor cannot unequivocally say, based on the results of a general blood test, what disease a person has, but can only make an assumption, consisting of a whole list of various pathologies. And in order to accurately diagnose the pathology, it is necessary, firstly, to take into account the clinical symptoms that a person has, and secondly, to appoint other additional studies that are more specific.
Thus, a general clinical blood test, on the one hand, provides a large amount of information, but on the other hand, this information requires clarification and can serve as the basis for further targeted examination.
Currently, a general blood test necessarily includes counting the total number of leukocytes, erythrocytes and platelets, determining the level of hemoglobin, erythrocyte sedimentation rate (ESR) and counting the number of different types of leukocytes - neutrophils, eosinophils, basophils, monocytes and lymphocytes (leukocyte formula). These parameters are determined in any laboratory and are mandatory components of a general blood test.
However, due to the widespread use in recent years of various automated analyzers, other parameters determined by these devices (for example, hematocrit, average volume of an erythrocyte, average hemoglobin content in one erythrocyte, average platelet volume, thrombocrit, number of reticulocytes, etc.). All these additional parameters are not required for a complete blood count, but since the analyzer automatically determines them, the laboratory staff includes them in the final test result.
In general, the use of analyzers makes it possible to perform a general blood test quickly and process a larger number of samples per unit time, but this method does not make it possible to deeply assess various pathological changes in the structure of blood cells. In addition, analyzers, just like people, make mistakes, and therefore their result cannot be considered the ultimate truth or more accurate than the result of manual calculations. And the number of indices automatically calculated by the analyzers is also not an indicator of their advantage, since they are calculated based on the main values of the analysis - the number of platelets, erythrocytes, leukocytes, hemoglobin, leukocyte formula, and therefore can also be erroneous.
That is why experienced doctors often ask laboratory staff in difficult cases to conduct a general blood test in manual mode, since this method is individual and allows you to identify such features and nuances that no apparatus is able to determine, working according to some average canons and norms. We can say that a general blood test in manual mode is like individual tailoring, like manual work, but the same analysis on an automatic analyzer is like mass production of clothes according to average patterns or like working on a conveyor. Accordingly, the difference between a blood test in manual mode and on an analyzer is the same as between manual individual production and conveyor assembly. For example, when working on the analyzer, anemia (low hemoglobin level) can be detected, but additional studies will have to be performed to determine its cause. If the blood test is carried out manually, then the laboratory assistant can determine the cause of anemia in most cases by the size and structure of red blood cells.
Naturally, with sufficient experience of the laboratory assistant, a manual general blood test is more accurate and complete than that done on the analyzer. But to perform such analyzes, you need staff of laboratory assistants and their rather painstaking and long training, but to work on the analyzer, a smaller number of specialists is enough, and you don’t have to train them so carefully with the layout of various nuances and "undercurrents". The reasons for switching to a simpler, but less informative general blood test on the analyzer are diverse, and everyone can isolate them on their own. We will not talk about them, since they are not the subject of the article. But as part of the description of the differences between manual and automatic CBC options, we should mention this.
Any version (manual or on the analyzer) of the general blood test is widely used in the medical practice of doctors of all specialties. Without it, the usual preventive annual examination and any examination about a person's disease is unthinkable.
Currently, blood samples from a vein and from a finger can be used for a complete blood count. The results of the study of both venous and capillary (from a finger) blood are equally informative. Therefore, you can choose the method of donating blood (from a vein or from a finger) that the person himself likes more and is better tolerated. However, if you have to donate blood from a vein for other tests, then it is rational to take a sample of venous blood for a general analysis in one go.
What does a general blood test show?
The result of a general blood test shows the functional state of the body and allows you to detect the presence of general pathological processes in it, such as, for example, inflammation, tumors, worms, viral and bacterial infections, heart attacks, intoxication (including poisoning with various substances), hormonal imbalance, anemia, leukemia, stress, allergies, autoimmune diseases, etc. Unfortunately, according to the result of a general blood test, one can only identify any of these pathological processes, but it is almost impossible to understand which organ or system is affected. To do this, the doctor must combine the data of the general blood test and the symptoms that the patient has, and only then can it be said that there is, for example, inflammation in the intestines or in the liver, etc. And then, based on the identified general pathological process, the doctor will prescribe additional necessary studies and laboratory tests to make a diagnosis. Thus, summarizing, we can say that a general blood test shows in which way (inflammation, dystrophy, tumor, etc.) a certain pathology occurs in a person. Together with the symptoms, according to the general blood test, it is possible to localize the pathology - to understand which organ was affected. But further for the diagnosis, the doctor prescribes clarifying tests and examinations. Thus, a complete blood count, together with symptoms, is an invaluable guide in the matter of diagnostics: "What to look for and where to look?".
In addition, a complete blood count allows you to track a person's condition during therapy, as well as in acute or incurable chronic diseases, and timely adjust the treatment. In order to assess the general condition of the body, a general blood test is also mandatory in preparation for planned and emergency operations, after surgical interventions to monitor complications, in case of injuries, burns and any other acute conditions.
Also, a general blood test must be given as part of preventive examinations for a comprehensive assessment of a person's health status.
Indications and contraindications for complete blood count
Indications for the delivery of a general blood test are the following situations and conditions:- Preventive examination (annual, upon admission to work, upon registration in educational institutions, kindergartens, etc.);
- Scheduled examination before admission to the hospital;
- Suspicion of existing infectious, inflammatory diseases (a person may be disturbed by fever, lethargy, weakness, drowsiness, pain in any part of the body, etc.);
- Suspicion of blood diseases and malignant tumors (a person may be disturbed by pallor, frequent colds, prolonged non-healing of wounds, fragility and hair loss, etc.);
- Monitoring the effectiveness of ongoing therapy for an existing disease;
- Monitoring the course of an existing disease.
Before the complete blood count (preparation)
Taking a complete blood count does not require special preparation, so there is no need to follow any special diet. It is enough to eat as usual, refraining from the consumption of alcoholic beverages during the day. However, since a complete blood count must be taken on an empty stomach, within 12 hours before taking a blood sample, you must refrain from any food, but you can drink liquid without restriction. In addition, 12 to 14 hours before taking a blood test, it is advisable to refrain from smoking, high physical exertion and strong emotional impressions. If for some reason it is impossible to refuse food within 12 hours, then a general blood test is allowed 4 to 6 hours after the last meal. Also, if it is not possible to exclude smoking, physical and emotional stress within 12 hours, then you should refrain from them for at least half an hour before taking the test.
Children should be reassured before taking a general blood test, as prolonged crying can cause an increase in the total number of leukocytes.
It is advisable to stop taking medications 2 to 4 days before the blood test, but if this is not possible, then you must definitely tell the doctor which medications are being taken.
It is also advisable to take a complete blood count before any other medical procedures. In other words, if a person has to undergo a comprehensive examination, then first you need to pass a general blood test, and only after that go for other diagnostic manipulations.
Delivery of a general blood test
General rules for taking a general blood test
For the production of a general analysis, blood is taken from a finger (capillary) or from a vein (venous) into test tubes. Within half an hour before taking the test, you should refrain from smoking, physical activity and strong emotional impressions, as these factors can distort the result. It is advisable to go to the clinic half an hour before the test, undress and sit quietly in the corridor, calming down and coming into a good mood. If a general blood test is given by a child, then you need to calm him down and try not to let him cry, since prolonged crying can also distort the result of the study. It is advisable for women not to take a complete blood count before and during menstruation, since during these physiological periods the result may be inaccurate.After passing a complete blood count, you can go about your usual activities, since taking a blood sample does not have a significant effect on well-being.
General analysis of blood from a finger
For the production of a general analysis, blood can be taken from a finger. To do this, the doctor or laboratory assistant wipes the fingertip of the non-working hand (left for right-handers and right for left-handers) with cotton wool moistened with an antiseptic (alcohol, Belasept liquid, etc.), and then quickly pierces the skin of the pad with a scarifier or lancet. Next, lightly squeezes the pad of the finger on both sides so that blood comes out. The first drop of blood is removed with a swab moistened with an antiseptic. Next, the laboratory assistant collects the protruding blood with a capillary and transfers it to a test tube. After taking the required amount of blood, cotton wool moistened with an antiseptic is applied to the puncture site, which must be held for several minutes to stop the bleeding. Blood is usually taken from the ring finger, but if after the puncture of the pad it is not possible to squeeze out even a drop of blood, then another finger is punctured. In some cases, you have to pierce several fingers to get the required amount of blood. If it is impossible to take blood from a finger, then it is taken from the earlobe or heel according to the same method as from the finger.
General analysis of blood from a vein
For the production of a general analysis, blood can be taken from a vein. Usually, the sampling is carried out from the cubital vein of the non-working arm (left for right-handers and right for left-handers), but if this is not possible, then blood is taken from the veins on the back of the hand or foot.To take blood from a vein, a tourniquet is applied to the arm just below the shoulder, they are asked to clench and unclench their fist several times so that the veins clearly stand out in the elbow area, swell and become visible. After that, the elbow area is treated with a swab moistened with an antiseptic, and a vein is pierced with a syringe needle. Entering the vein, the nurse pulls the plunger of the syringe towards herself, drawing blood. When the required amount of blood has been collected, the nurse removes the needle from the vein, pours the blood into a test tube, and puts cotton wool moistened with an antiseptic on the puncture site and asks to bend the arm at the elbow. The hand must be held in this position for several minutes until the bleeding stops.
On an empty stomach or not to take a general blood test?
A complete blood count should only be taken on an empty stomach, as eating food causes an increase in the number of blood leukocytes. This phenomenon is called - alimentary (food) leukocytosis, and is considered the norm. That is, if a person passes a general blood test within the next 4 to 6 hours after eating, and receives a large number of leukocytes, then this is the norm, and not a sign of pathology. That is why, in order to obtain a reliable and accurate result, a complete blood count should always be taken only on an empty stomach after the previous 8-14 hour fast. Accordingly, it is understandable why it is recommended to take a general blood test in the morning on an empty stomach - when, after a night's sleep, a hungry period of sufficient duration passes.
If for some reason it is impossible to take a general blood test in the morning on an empty stomach, then it is allowed to take the test at any time of the day, but only at least 4 hours after the last meal. Thus, at least 4 hours should pass from the moment a person has eaten to taking a general blood test (but it is better if more passes - 6-8 hours).
Indicators of the general blood test
The following indicators are mandatory in the general blood test:- Total number of red blood cells (may be referred to as RBC);
- Total white blood cell count (may be referred to as WBC);
- Total platelet count (may be referred to as PLT);
- Hemoglobin concentration (may be referred to as HGB, Hb);
- Erythrocyte sedimentation rate (ESR) (may be referred to as ESR);
- Hematocrit (may be referred to as HCT);
- The number of different types of leukocytes in percent (leukocyte formula) - neutrophils, basophils, eosinophils, lymphocytes and monocytes. The leukocyte formula also separately indicates the percentage of young and blast forms of leukocytes, plasma cells, atypical mononuclear cells, if any are found in a blood smear.
In addition to these mandatory parameters, additional indicators may be included in the general blood test. These indicators are not determined specifically, they are automatically calculated by the hematology analyzer on which the analysis is performed. Depending on the programs embedded in the analyzer, the following parameters can be additionally included in the complete blood count:
- Absolute content (number) of neutrophils (may be referred to as NEUT#, NE#);
- Absolute content (number) of eosinophils (may be referred to as EO#);
- Absolute content (number) of basophils (may be referred to as BA#);
- Absolute content (number) of lymphocytes (may be referred to as LYM#, LY#);
- Absolute content (number) of monocytes (may be referred to as MON#, MO#);
- Mean erythrocyte volume (MCV);
- Average content of hemoglobin in one erythrocyte in picograms (MCH);
- The concentration of hemoglobin in one erythrocyte in percent (MCHC);
- The width of the distribution of erythrocytes by volume (may be referred to as RDW-CV, RDW);
- Mean platelet volume (MPV);
- Platelet distribution width by volume (may be referred to as PDW);
- The relative content of monocytes, basophils and eosinophils in percent (may be referred to as MXD%, MID%);
- Absolute content (number) of monocytes, basophils and eosinophils (may be referred to as MXD#, MID#);
- The relative content of immature granulocytes - neutrophils, basophils and eosinophils as a percentage (may be referred to as IMM% or young forms);
- The absolute content (number) of immature granulocytes - neutrophils, basophils and eosinophils (may be referred to as IMM # or young forms);
- The relative content of all granulocytes - neutrophils, basophils and eosinophils as a percentage (may be referred to as GR%, GRAN%);
- The absolute content (number) of all granulocytes - neutrophils, basophils and eosinophils (may be referred to as GR #, GRAN #);
- The relative content of atypical lymphocytes in percent (may be referred to as ATL%);
- Absolute content (number) of atypical lymphocytes (may be referred to as ATL#).
The above additional parameters are included in the complete blood count in cases where they are automatically calculated by the analyzer. But since the analyzers can be different, the list of such additional parameters of the general blood test is also different, and depends on the type of hematological apparatus. In principle, these additional parameters are not too necessary, since if necessary, the doctor can calculate them independently based on the main indicators of the general blood test. Therefore, in fact, in practice, doctors pay little attention to all additional parameters in the general blood test calculated by the analyzer. Accordingly, you should not be upset if there are few or no specified additional parameters in the general blood test, since they are, in principle, not needed.
The norms of a general blood test in adults
You need to know that an adult is considered a person who has reached the age of 18. Accordingly, the norms of various indicators of the general blood test for adults refer to people over 18 years of age. Below we will consider what are the normal values of both the main and additional parameters of the general blood test for adults. At the same time, you need to know that averaged normal values are given, and more accurate limits of the norms need to be clarified in each particular laboratory, since they may differ depending on the region, the characteristics of the work of analyzers and laboratory assistants, the reagents used, etc. So, the total number of red blood cells is counted in pieces per liter or microliter. Moreover, if the count is per liter, then the number of red blood cells is indicated as follows: X T / l, de X is the number, and T / l is the tera per liter. The word tera means the number 1012. Thus, if the result of the analysis is 3.5 T / l, then this means that 3.5 * 1012 pieces of red blood cells circulate in one liter of blood. If the count is per microliter, then the number of red blood cells is indicated by X million / μl, where X is the number, and million / μl is a million per microliter. Accordingly, if it is indicated that erythrocytes are 3.5 million / μl, then this means that 3.5 million erythrocytes circulate in one microliter. It is characteristic that the number of erythrocytes in T / l and million / μl coincides, since there is only a mathematical difference between them in a unit of measurement of 106. That is, a tera is more than a million by 106, and a liter is more than a microliter by 106, which means that the concentration of erythrocytes in T/l and mln/µl is exactly the same, and only the unit of measurement differs.
Normally, the total number of red blood cells is 3.5 - 4.8 in adult women and 4.0 - 5.2 in adult men.
The total number of platelets in the blood is normal in men and women is 180 - 360 g / l. The unit of measure G/l means 109 pieces per litre. Thus, if, for example, the number of platelets is 200 g / l, then this means that 200 * 109 platelets circulate in a liter of blood.
The total number of leukocytes is normal in men and women 4 - 9 g / l. Also, the number of leukocytes can be counted in thousand / μl (thousands per microliter), and it is exactly the same as in G / l, since both the number of pieces and the volume differ by 106, and the concentration is the same.
According to the leukocyte formula, normal blood in adult men and women contains various types of leukocytes in the following ratios:
- Neutrophils - 47 - 72% (of which 0 - 5% are young, 1 - 5% are stab and 40 - 70% are segmented);
- Eosinophils - 1 - 5%;
- Basophils - 0 - 1%
- Monocytes - 3 - 12%;
- Lymphocytes - 18 - 40%.
The concentration of hemoglobin is normal in adult women 120 - 150 g / l, and in adult men - 130 - 170 g / l. In addition to g/l, hemoglobin concentration can be measured in g/dl and mmol/l. To convert g/l to g/dl, divide the g/l value by 10 to get the g/dl value. Accordingly, to convert g / dl to g / l, you need to multiply the hemoglobin concentration value by 10. To convert the value in g / l to mmol / l, you need to multiply the number in g / l by 0.0621. And to convert mmol / l to g / l, you need to multiply the value of hemoglobin concentration in mmol / l by 16.1.
Normal hematocrit for adult women is 35 - 47, and for men - 39 - 54.
The erythrocyte sedimentation rate (ESR) in women aged 17–60 is normally 5–15 mm/hour, and in women over 60 years old it is 5–20 mm/hour. ESR in men 17-60 years old is normally less than 3-10 mm/hour, and over 60 years old - less than 3-15 mm/hour.
The average erythrocyte volume (MCV) is normally 76-103 fl in men and 80-100 fl in women.
The concentration of hemoglobin in one erythrocyte (MCHC) is normally 32 - 36 g / dl.
The distribution width of erythrocytes by volume (RDW-CV) is normally 11.5 - 14.5%.
The average platelet volume (MPV) in normal adult men and women is 6-13 fl.
The platelet distribution width by volume (PDW) is normally 10–20% in men and women.
The absolute content (number) of lymphocytes (LYM#, LY#) in normal adults is 1.2 - 3.0 G/l or thousand/µl.
The relative content of monocytes, basophils and eosinophils (MXD%, MID%) is normally 5-10%.
The absolute content (number) of monocytes, basophils and eosinophils (MXD#, MID#) is normally 0.2 - 0.8 G / l or thousand / μl.
The absolute content (number) of monocytes (MON#, MO#) is normally 0.1 - 0.6 G/l or thousand/µl.
The absolute content (number) of neutrophils (NEUT #, NE #) is normally 1.9 - 6.4 G / l or thousand / μl.
The absolute content (number) of eosinophils (EO#) is normally 0.04 - 0.5 G / l or thousand / μl.
The absolute content (number) of basophils (BA#) is normally up to 0.04 G/l or thousand/µl.
The relative content of immature granulocytes - neutrophils, basophils and eosinophils as a percentage (IMM% or young forms) is normally no more than 5%.
The absolute content (number) of immature granulocytes - neutrophils, basophils and eosinophils (IMM # or young forms) is normally not more than 0.5 G / l or thousand / μl.
The relative content of all granulocytes - neutrophils, basophils and eosinophils (GR%, GRAN%) is normally 48 - 78%.
The absolute content (number) of all granulocytes - neutrophils, basophils and eosinophils (GR #, GRAN #) is normally 1.9 - 7.0 G / l or thousand / μl.
The relative content of atypical lymphocytes (ATL%) is normally absent.
The absolute content (number) of atypical lymphocytes (ATL#) is absent in the norm.
Table of norms for a general blood test in adults
Below, for ease of perception, we present the norms of a general blood test for adults in the form of a table.| Indicator | Norm for men | Norm for women |
| Total number of red blood cells | 4.0 – 5.2 T/L or ppm | 3.5 – 4.8 T/l or ppm |
| Total number of leukocytes | 4.0 – 9.0 G/l or thousand/µl | 4.0 – 9.0 G/l or thousand/µl |
| Neutrophils (neutrophil granulocytes) in general | 47 – 72 % | 47 – 72 % |
| Young neutrophils | 0 – 5 % | 0 – 5 % |
| stab neutrophils | 1 – 5 % | 1 – 5 % |
| segmented neutrophils | 40 – 70 % | 40 – 70 % |
| Eosinophils | 1 – 5 % | 1 – 5 % |
| Basophils | 0 – 1 % | 0 – 1 % |
| Monocytes | 3 – 12 % | 3 – 12 % |
| Lymphocytes | 18 – 40 % | 18 – 40 % |
| Hemoglobin concentration | 130 – 170 g/l | 120 – 150 g/l |
| Total Platelet Count | 180 – 360 g/l or thousand/µl | 180 – 360 g/l or thousand/µl |
| Hematocrit | 36 – 54 | 35 – 47 |
| Sedimentation rate of erythrocytes | 17 - 60 years - 3 - 10 mm/hour Over 60 years old - 3 - 15 mm/hour | 17 - 60 years old - 5 - 15 mm/h Over 60 years old - 5 - 20 mm/hour |
| Mean erythrocyte volume (MCV) | 76 - 103 fl | 80 - 100 fl |
| Mean erythrocyte hemoglobin (MCH) | 26 - 35 pg | 27 - 34 pg |
| Hemoglobin concentration in one erythrocyte (MCHC) | 32 - 36 g/dl or 320 – 370 g/l | 32 - 36 g/dl or 320 – 370 |
| RBC Distribution Width by Volume (RDW-CV) | 11,5 – 16 % | 11,5 – 16 % |
| Mean platelet volume (MPV) | 6 - 13 fl | 6 - 13 fl |
| Platelet Distribution Width by Volume (PDW) | 10 – 20 % | 10 – 20 % |
The table above shows the main indicators of the general blood test with their normal values for men and women.
In the table below, we present the values of the norms of additional indicators, which are the same for men and women.
| Indicator | Norm |
| Absolute content (number) of lymphocytes (LYM#, LY#) | 1.2 – 3.0 G/l or thousand/µl |
| Relative content of monocytes, basophils and eosinophils (MXD%, MID%) | 5 – 10 % |
| Absolute content (number) of monocytes, basophils and eosinophils (MXD#, MID#) | 0.2 – 0.8 g/l or thousand/µl |
| Absolute content (number) of monocytes (MON#, MO#) | 0.1 – 0.6 G/l or thousand/µl |
| Absolute content (number) of neutrophils (NEUT#, NE#) | 1.9 - 6.4 G/l or thousand/µl |
| Absolute content (number) of eosinophils (EO#) | 0.04 – 0.5 g/l or thousand/µl |
| Absolute content (number) of basophils (BA#) | up to 0.04 g/l or thousand/µl |
| Relative content of immature granulocytes (IMM%) | Not more than 5% |
| Absolute content (number) of immature granulocytes (IMM#) | Not more than 0.5 g / l or thousand / μl |
| Relative content of all granulocytes (GR%, GRAN%) | 48 – 78 % |
| Absolute content (number) of all granulocytes (GR#, GRAN#) | 1.9 – 7.0 G/l or thousand/µl |
| Relative (ATL%) and absolute (ATL#) content of atypical lymphocytes | Missing |
Complete blood count in children - norms
Below, for ease of perception, we indicate the norms of indicators of a general blood test for children of different ages. It should be remembered that these norms are averages, they are given only for approximate orientation, and the exact values of the norms must be clarified in the laboratory, since they depend on the types of equipment used, reagents, etc.| Indicator | Norm for boys | Norm for girls |
| Total number of red blood cells | ||
