One of the primary challenges in diagnostic testing is ensuring the accuracy of results. This requires medical laboratories follow strict protocols and adhere to a code of conduct. Medical laboratory professionals must also be trained to properly collect, handle and analyze samples to avoid contamination and ensure the validity of results.

Another challenge is maintaining the confidentiality of patient information. In diagnostic testing, sensitive information about a patient’s health can be revealed and it is the responsibility of healthcare providers to ensure that this information is protected and not disclosed to unauthorized individuals.

In addition to these practical challenges, there are also important ethical considerations to keep in mind. The diagnostic process must be guided by the principles of medical ethics, which emphasize on the importance of treating patients with dignity and respect, and balancing their right to know with the need to protect their privacy. The ethical principles of autonomy, beneficretion and informed consent must be upheld, giving patients the right to make informed decisions about their health and medical treatment.

Another important ethical consideration in diagnostic testing is the principle of non-maleficence, which requires healthcare providers to avoid causing harm to patients. This is especially important in the context of diagnostic testing, as patients may experience psychological or emotional harm as a result of receiving results that are unexpected or difficult to understand.

Finally, it is important to remember that diagnostic testing is a complex process that must be carried out in a way that respects human values and ethics. Healthcare providers must work together to ensure that patients are treated with kindness and compassion and that the diagnostic process is guided by the highest standards of ethics and professionalism.

In conclusion, the challenges and ethical considerations in diagnostic testing are numerous and complex. It is the responsibility of healthcare providers, medical laboratories, hospitals and all involved parties to ensure that this important process is carried out in a way that protects the well-being of patients and upholds the highest standards of medical ethics. By doing so, we can ensure that patients receive the best possible care and that the diagnostic process contributes to their physical and emotional well-being.

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Biomarkers are produced by cancerous cell or are secreted in response to cancers. These biomarkers are usually detected in blood or urine. The markers can be used for predicting risk of primary or secondary tumor. Occasionally, non-cancerous situations may also show increased level of some tumor markers than in normal conditions. In addition, some cancer patients does not have elevated level of tumor marker. Tumor markers are not the main parameters for diagnosis of cancer but may be employed as laboratory test as supportive to the diagnosis.

Types of Cancer Markers

The cancer markers can be hormones, oncofetal antigens, isoenzyme, proteins, mitochondrial markers, mucin, glycoproteins and molecular markers. Some of the biomarkers are calcitonin, human chorionic gonadotrophin, α fetoproteins, carcino-embryonic antigen, prostatic acid phosphatase, Immunoglobulins, catalase, mtDNA, cancer 125, p53, adenomatous polyposis coli etc.

Uses of Tumor Marker Detection

Though tumor markers are generally unsatisfactory for screening tests of occult cancers, when a specific tumor was diagnosed by means of a marker, the biomarker can be used as follow up of the treatment. Their level may also show the progression of the disease. Increased levels of tumor markers on detection results can be, but are not at all times bothersome. Though alteration of tumor marker levels can be the reason to alert, other noncancerous conditions may show variation in test result. The laboratory conditions for performing the tests can also change the results.

Advantages Of Tumor Marker Detection

• Tumor markers help in screening and early detection of cancer. Screening of tumor markers means to search for tumor markers in asymptomatic persons, whereas early detection means to detect markers at early stage of cancer.
• They help in the diagnosis of cancer. Both biopsy and tumor markers are employed to diagnose cancer. It is also capable to detect the origin of cancer in patients who are in advanced stages.
• They are also used to monitor the response to therapy. The originally elevated tumor marker level reduces on treatment indicating that the treatment is effective in reducing the cancer. Whereas if the level of tumor marker does not reduce on treatment, then the treatment is not efficient and should be changed.
• It can be used as prognosis of disease progression. Types of tumor marker aid in assessing the type of cancer and even the types of drugs to be used for treatment. 
• They indicate relapse of cancer in the course of follow-up period. Markers have also been employed for detecting cancers which recur subsequently initial treatment. Few tumor markers are useful in indicating the complete cure of cancer.

Disadvantages of Tumor Marker Detection

• As there is biological variability in patient’s sample, tumor markers are unable to predict specific cancer states.

• Variation in sample collection, handling or storage and reporting techniques can result into alteration in the protein profile of a given sample. Therefore, the methods of sample processing should be standardised before analysing the test results.
• The amount of cancer biomarkers is very less in early stage of cancer which makes it difficult to detect.

Methods for detection of tumor markers

Tumor markers are detected by antigen-antibody based techniques such as spectrophotometry, chromatographic techniques, radio-immunoassay (RIA), enzyme linked immunosorbent assay (ELISA), precipitin tests, flow-cytometry, immunohistochemistry and molecular genetic methods. Molecular genetic markers can be detected by polymerase chain reaction (PCR), reverse transcriptase- polymerase chain reaction (RT-PCR), southern blot hybridization (SB) and fluorescent in-situ hybridization (FISH).

Submitted by

Dr Pratyusha Kar

Faculty of Paramedical Sciences

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FNAC is a rapid & cost-effective methodology.

It helps to diagnose and differentiate between a cancerous and noncancerous nodule.

FNAC is most often the diagnostic of palpable mass lesions. 

The technique was introduced in the 1930s by Martin and Ellis in the USA.

Since the 1950s, it has been used extensively in Scandinavia and Holland.

Fine needle for aspiration was first introduced in the 1950s by Lopez-Cardozo in Sweden.

These are four types

1)FNAC (direct aspiration)

2) Ultrasound-Guided FNAC 

3)Endoscopy-Guided Ultrasound FNAC 

4) Computed Tomography (CT)-Guided FNAC

FNAC (Direct Aspiration)

It’s a common technique. In which the FNAC samples were taken in hospital wards by a nurse and in a pathology lab by a pathologist.

Requirements

• Examination couch with following facilities-

Pillows, disposable bed sheet, blanket

 and a screen for privacy.

• Solutions and Equipment’s: –

Alcohol swab, 95% alcohol & methanol, staining solution, pistol handle, needle (22g or 23g).

• Other requirements are…

Gloves, Mask, Bandage and micropore, Cotton, Lead pencil & pen, Consent form & Test request form etc.

Procedure

1)Initially matches all details of patients.

2)After that take a mask and wear gloves.

3)Now, identify palpable nodules and feel with tips of two middle fingers of the right hand. 

4)Aspiration:

•The needle is inserted into the nodule or lesion.

•The plunger pulled back.

•The needle is moved, in a straight line under the nodule or lesion.

•The plunger is released.

•After withdrawing, remove the needle.

5)Place the collected material on the slide & make a smear.

6)Smears are immediately fixed in 95% alcohol & methanol.

7)Stained with PAP & Giemsa staining.

8)Microscopy on 10X and 40X.

Advantages:

It is A cost-effective procedure, Economical,

Easy to perform, least invasive, No Anesthesia & Hospitalization is required, Extremely satisfactory results. 

An exact cytological diagnosis is available before definitive surgery is planned.

Complication:

The complication is rare-

Minor bleeding, Hematoma, Infection. Read More

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