Help Understanding Blood Test Results

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TiredandTroubled
Posts: 22
Joined: Sat Jul 10, 2021 7:11 am

Help Understanding Blood Test Results

Postby TiredandTroubled » Wed Jul 21, 2021 8:18 am

I just got my blood test biopsy results after my colonoscopy (which identified a 7cm mass in my sigmoid colon, left side) and sigmoidoscopy. Here is what I know so far:

Biopsy
1. Superficial fragments of rectal mucosa with at least high grade dysplasia / intra-mucosal carcinoma

(It says 'rectal' but according to the colonoscopy the tumor is in my sigmoid?)

Immunohistochemical staining:
MLH1: staining present
MLH2: staining present
MSH6: staining present
PMS2:staining present
DNA mismatch repair proteins tested by immunohistochemistry are retained in the tumor.

Does this mean it's not lynch?

Here are the parts of my blood work that are out of range - can anyone help me understand?

Chemistry
Anion Gap PI: 7 (low)

Hematology
RDW: 11.6 (low)

I have a CEA of 16.7

According to the CT scan there doesn't appear to be any spread to liver or lungs. But it says my gallbladder is collapsed (unrelated?)
29F DX 7/19
CC Sigmoid Colon
Size: 7CM
CEA before surgery: 16

User avatar
beach sunrise
Posts: 500
Joined: Thu Mar 05, 2020 7:14 pm

Re: Help Understanding Blood Test Results

Postby beach sunrise » Wed Jul 21, 2021 10:53 pm

I don't know alot about anion gap except it showed up as a panel on the CHEM 8 test before port removal. Surgeon said they check it for kidney function to be sure I can handle being put to sleep. Mine was 14mmol/L and port removal was a GO. Not sure if any of this would apply to you or not. I would definitely ask what this panel means for you/why they tested it.
Was your bloodwork a CHEM 14 or what?
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

User avatar
Jacques
Posts: 600
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Help Understanding Blood Test Results

Postby Jacques » Thu Jul 22, 2021 7:31 am

Regarding blood tests, please understand that:

  • There are different types of blood-test panels. Some are more extensive than others.
    .
  • The two main types of blood test panels are the ones used typically for annual physical exams. These are:

    • Serum chemistry panels, otherwise known as CHEM 8, CHEM 15, CHEM 25, etc, depending on how many tests the machine is programmed to handle. These are also sometimes called, Basic Metabolic Panel, Comprehensive Metabolic Panel, etc. When reviewing your bloodwork it is important to notice which kind of panel the doctor has requested, because these panels do not test for everything. If all of your bloodwork tests turn out to be normal, there still might be a problem because your particular panel might not be testing for a particular area where you do indeed have a problem.
      .
    • CBC (Complete Blood Count) panels, including CBC+differential. These panels test whether or not your blood cells are functioning as expected.
What you get depends on what the specific panel is designed to deliver. And there is always the possibility of adding extra, specialized tests that are not included in any of the default panels. For example, you may have to request a thyroid test specifically if your default panel does not include any thyroid tests and you need thyroid monitoring. The tests that you mentioned, "Anion gap test" and the "Red Blood Cell Distribution Width (RDW) test" fall in this area: They are specific tests that the doctor wants to do in order to check on something that is not in one of the ordinary blood-test panels. You would have to ask the doctor why he needed to have the information provided by these tests.

Then there are other blood tests that fall in the genetics area. These tests will test for specific mutations that are present in the DNA in all cells of your body from birth. These tests are done mainly to check on inherited DNA mutations that are passed on from one generation to another and are present at birth in all cells of the body. These are tests like the Hereditary Non-Polyposis Colon Cancer (HNPCC) test for Lynch syndrome, and the Familial Adenomatous Polyposis (FAP) test. These tests are not ordinarily done unless there is evidence of a family history of colon cancer.

Then there are the new Circulating Tumor DNA (ctDNA) tests that are designed to detect fragments of tumor DNA that are now circulating in the blood stream. These tests are done for early warning of metastases that may be developing but that are not yet visible on any scans. They are rather expensive and may not be covered by insurance. Then there are the other genetic tests that test for a whole range of possible DNA mutations, like the Foundation One tests, but they, too, are extremely expensive and are probably not worth the cost except in very special cases.


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