Clinical significance and diagnostic value of serum CEA, CA19-9 and CA72-4 in patients with gastric cancer

TLDR

The study aims to assess the diagnostic value of serum CEA, CA19‑9, and CA72‑4 for gastric cancer and to develop a discriminant equation to predict GC presence. Researchers measured CEA, CA19‑9, and CA72‑4 in 2,288 gastric cancer patients and 1,869 controls, then built and validated a predictive equation using a training–testing split. The markers were elevated in GC, but individual sensitivities were 20–28%; combined sensitivity rose to 48%, and the new equation achieved higher diagnostic accuracy than marker combinations. Published July 2, 2016 by Sun Yat‑sen University Cancer Center; authors include Yao Liang, Wei Wang, Cheng Fang, Seeruttun Sharvesh Raj, Wan‑Ming Hu, Qi‑Wen Li, and Zhi‑Wei Zhou.

Abstract

// Yao Liang 1, * , Wei Wang 1, * , Cheng Fang 1, * , Seeruttun Sharvesh Raj 1 , Wan-Ming Hu 2 , Qi-Wen Li 3 , Zhi-Wei Zhou 1 1 Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China 2 Department of Pathological Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China 3 Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China * Co-first authors Correspondence to: Zhi-Wei Zhou, email: [e-mail] Keywords: CEA, CA19-9, CA72-4, diagnosis, gastric cancer Received: February 26, 2016 Accepted: June 03, 2016 Published: July 02, 2016 ABSTRACT Aims: To evaluate the clinical significance of multiple serum tumor markers (TMs) in the diagnosis of gastric cancer (GC) and establish an accurate discriminant equation to identify the presence of GC. Results: The serum levels of CEA, CA19-9 and CA72-4 were higher in the GC group than in the control group ( P < 0.005). The sensitivity of CEA, CA19-9 and CA72-4 in the diagnosis of GC was 20.1–27.6% individually and increased to 48.2% when they were considered in combination. By using the optimal cut-off value, the sensitivity of CEA, CA19-9 and CA72-4 for the diagnosis of GC was improved but remained unsatisfactory. In addition, we developed the equation Y = –2.185 – 0.015 X1 + 0.180 X2 + 1.226 X3 + 1.505 X4 + 2.749 X5 (X1 = Age, X2 = Sex, X3 =CEA, X4 = CA19-9 and X5 = CA72-4) to predict the presence of GC. This has better accuracy and diagnostic efficiency compared to the combination of TMs. Methods: Serum carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9)and cancer antigen 72-4 (CA72-4) levels were measured in a total of 2288 patients with GC and 1869 healthy volunteers or patients with benign gastric diseases. We established a diagnostic equation using a portion of the data (training set), and validate its accuracy using the other portion of the data (testing set) . Conclusions: The diagnostic equation increases the accuracy rate for the diagnosis of GC and will be helpful in the clinic.