DOI QR코드

DOI QR Code

Tumor Markers for Diagnosis, Monitoring of Recurrence and Prognosis in Patients with Upper Gastrointestinal Tract Cancer

  • Jing, Jie-Xian (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Wang, Yan (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Xu, Xiao-Qin (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Sun, Ting (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Tian, Bao-Guo (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Du, Li-Li (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Zhao, Xian-Wen (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Han, Cun-Zhi (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital)
  • Published : 2015.01.06

Abstract

To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of these tumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancer between January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA. The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%, 25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 had higher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCC was the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 and CA24-2, SCC and CA72-4 was significantly associated with pathological types (p<0.05) and TNM staging (p<0.05). Correlation analysis showed that CA24-2 was significantly correlated with CA19-9 (r=0.810, p<0.001). The levels of CEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasis and recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperative CA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combined detection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC; CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA and CA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumor recurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis of patients with upper GIT cancer.

Keywords

References

  1. Abdullah S, Mustafa K, Gurhan B, et al (2013). CEA and CA 19-9 are still valuable markers for the prognosis of colorectal and gastric cancer patients. Asian Pac J Cancer Prev, 14, 4289-94. https://doi.org/10.7314/APJCP.2013.14.7.4289
  2. Buyru N, Tigli H, Duranyildiz D, et al (2006). Molecular detection of squamous cell carcinoma antigen transcripts in peripheral blood of cancer patients. Clin Chem Lab Med, 44, 538-41.
  3. Bates SE (1991). Clinical applications of serum tumor markers. Ann Intern Med, 115, 623-38. https://doi.org/10.7326/0003-4819-115-8-623
  4. Chen SW, Liang JA, Hung YC, et al (2008). Clinical implications of elevated pretreatment carcinoembryonic antigen in patients with advanced squamous cell carcinoma of the uterine cervix. Tumour Biol, 29, 255-61. https://doi.org/10.1159/000152943
  5. Carpelan-Holmstro M, Louhimo J, Stenman UH, et al (2002). CEA, CA19-9 and CA72-4 improve the diagnostic accuracy in gastrointestinal cancers. Anticancer Res, 22, 2311-6.
  6. Choi SR, Jang JS, Lee JH, et al (2006). Role of serum tumor markers in monitoring for recurrence of gastric cancer following radical gastrectomy. Dig Dis Sci, 51, 2081-6. https://doi.org/10.1007/s10620-006-9166-5
  7. Edge SB, Compton CC (2010). The american joint committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 17, 1471-4. https://doi.org/10.1245/s10434-010-0985-4
  8. Fernandes LL, Martins LC, Nagashima CA, et al (2007). CA72-4 antigen levels in serum and peritoneal washing in gastric cancer. Correlation with morphological aspects of neoplasia. Arq Gastroenterol, 44, 235-9. https://doi.org/10.1590/S0004-28032007000300011
  9. Feng JF, Huang Y, Chen QX (2013). Prognostic value of preoperative serum CA 242 in esophageal squamous cell carcinoma cases. Asian Pac J Cancer Prev, 14, 1803-6. https://doi.org/10.7314/APJCP.2013.14.3.1803
  10. Grinbaum R, Nissan A, Beglaibter N, et al (2006). The prognostic value of CA 19-9 in the preoperative work-up of pancreatic cancer patients. Harefuah, 145, 793-4, 863.
  11. Goral V, Yesilbagdan H, Kaplan A, et al (2007). Evaluation of CA 72-4 as a new tumor marker in patients with gastric cancer. Hepatogastroenterology, 54, 1272-5.
  12. Gao ZL, Zhang C, Du GY, et al (2007). Clinical significance of changes in tumor markers, extracellular matrix, MMP-9 and VEGF in patients with gastric carcinoma. Hepatogastroenterology, 54, 1591-5.
  13. Gupta G, Sharma R, Chattopadhyay TK, et al (2007). Clinical significance of sperm protein 17 expression and immunogenicity in esophageal cancer. Int J Cancer, 120, 1739-47. https://doi.org/10.1002/ijc.22463
  14. Gao ZL, Zhang C, Du GY, et al (2007). Clinical significance of changes in tumor markers, extracellular matrix, MMP-9 and VEGF in patients with gastric carcinoma. Hepatogastroenterology, 54, 1591-5.
  15. Gwak HK, Lee JH, Park SG (2014). Preliminary evaluation of clinical utility of CYFRA 21-1, CA 72-4, NSE, CA19-9 and CEA in stomach cancer. Asian Pac J Cancer Prev, 15, 4933-8. https://doi.org/10.7314/APJCP.2014.15.12.4933
  16. Jing JX, Xu XQ, Du LL, et al (2013). Clinical assessment and prognostic evaluation of tumor markers in patients with gastric cancer. Int J Biol Markers, 28, 192-200. https://doi.org/10.5301/jbm.5000023
  17. Kosugi S, Nishimaki T, Kanda T, et al (2004). Clinical significance of serum carcinoembryonic antigen, carbohydrate antigen 19-9, and squamous cell carcinoma antigen levels in esophageal cancer patients. World J Surg, 28, 680-5.
  18. Kosugi S, Nishimaki T, Kanda T, et al (2004). Clinical significance of serum carcinoembryonic antigen, carbohydrate antigen 19-9, and squamous cell carcinoma antigen levels in esophageal cancer patients. World J Surg, 28, 680-5.
  19. Lin Y, Totsuka Y, He Y, et al (2013). Epidemiology of esophageal cancer in Japan and China. J Epidemiol, 23, 233-42. https://doi.org/10.2188/jea.JE20120162
  20. Molina R, Auge JM, Filella X, et al (2005). Pro-gastrin-releasing peptide (proGRP) in patients with benign and malignant diseases: comparison with CEA, SCC, CYFRA 21-1 and NSE in patients with lung cancer. Anticancer Res, 25, 1773-8.
  21. Marrelli D, Roviello F, De Stefano A, et al (2004). Risk factors for liver metastases after curative surgical procedures for gastric cancer: a prospective study of 208 patients treated with surgical resection. J Am Coll Surg, 198, 51-8. https://doi.org/10.1016/j.jamcollsurg.2003.08.013
  22. Marrelli D, Roviello F, De Stefno A, et al (1999). Prognostic significance of CEA, CA19-9 and CA72-4 preoperative serum levels in gastric carcinoma. Oncology, 57, 55-62. https://doi.org/10.1159/000012001
  23. Mandorwski S, Lour Lourenco LG, Forones NM, et al (2002). CA72-4 and CEA in serum and peritoneal washing in gastric cancer. Arq Gastroenterol, 39, 17-21. https://doi.org/10.1590/S0004-28032002000100004
  24. Mao YS, Zhang DC, Zhao XH, et al (2003). Significance of CEA, SCC and Cyfra21-1 serum test in esophageal cancer. Zhonghua Zhong Liu Za Zhi, 25, 457-60.
  25. Nishimaki T, Suuki T, Kanda T, et al (1999). Extended radical esophagectomy for superficially invasive carcinoma of the esophagus. Surgery, 125, 142-7. https://doi.org/10.1016/S0039-6060(99)70257-6
  26. Nishimaki T, Tanaka O, Ando N, et al (1999). Evaluation of the accuracy of preoperative staging in thoracic esophageal cancer. Ann Thorac Surg, 68, 2059-64. https://doi.org/10.1016/S0003-4975(99)01171-6
  27. Nakamura T, Ide H, Eguchi R, et al (1998). CYFRA21-1 as a tumor marker for squamous cell carcinoma. Esophagus, 11, 35-9.
  28. Oremek GM, Sapoutzis N, Lorenz M, et al (2003). Phospholipids, tumour marker and beta-CrossLaps in diagnosis of gastric carcinoma. Anticancer Res, 23, 859-63.
  29. Patriti A, Graziosi L, Baffa N, et al (2007). Postoperative followup of gastric adenocarcinoma with neoplastic markers and 18-FDG-PET/TC. Ann Ital Chir, 78, 481-5.
  30. Park YP, Choi SC, Kim JH, et al (2007). Up-regulation of Mac-2 binding protein by hTERT in gastric cancer. Int J Cancer, 120, 813-20. https://doi.org/10.1002/ijc.22369
  31. Schneider J, Schulze G (2003). Comparison of tumor M2-pyruvate kinase (tumor M2-PK), carcinoembryonic antigen (CEA), carbohydrate antigens CA 19-9 and CA 72-4 in the diagnosis of gastrointestinal cancer. Anticancer Res, 23, 5089-93.
  32. Safi F, Kuhns V, Beger HG, et al (1995). Comparison of CA72-4, CA19-9 and CEA in the diagnosis and monitoring of gastric cancer. Int J Biol Markers, 10, 100-6.
  33. Shimada H, Nabeya Y, Okazumi S, et al (2003). Prediction of survival with squamous cell carcinoma antigen in patients with resectable esophageal squamous cell carcinoma. Surgery, 133, 486-94. https://doi.org/10.1067/msy.2003.139
  34. Takemura M, Osugi H, Takada N, et al (2004). The prognostic factors after radical esophagectomy for esophageal cancer with sensitive preoperative CEA. Hepatogastroenterol, 51, 159-62.
  35. Takahashi Y, Takeuchi T, Sakamoto J, et al (2003). The usefulness of CEA and/or CA19-9 in monitoring for recurrence in gastric cancer patients: a prospective clinical study. Gastric Cancer, 6, 142-5. https://doi.org/10.1007/s10120-003-0240-9
  36. Tian SB, Yu JC, Kang WM, et al (2014). Combined detection of CEA, CA 19-9, CA 242 and CA 50 in the diagnosis and prognosis of resectable gastric cancer. Asian Pac J Cancer Prev, 15, 6295-300. https://doi.org/10.7314/APJCP.2014.15.15.6295
  37. Ucar E, Semerci E, Ustun H, et al (2008). Prognostic value of preoperative CEA, CA19-9, CA72-4, and AFP levels in gastric cancer. Adv Ther, 25, 1075-84. https://doi.org/10.1007/s12325-008-0100-4
  38. Wu H, Cheng NS, Zhang YG, et al (2007). Improved early diagnosis of cystadenocarcinoma of the pancreas. Hepatobiliary Pancreat Dis Int, 6, 87-91.
  39. Wang DC, Wang LD, Zheng S, et al (2005). The application of surface-enhanced laser desorption/ionization-time of flightmass spectrometry in diagnosing dysplasia and chronic atrophic gastric-carditis in population with high risk of gastric-cardia adenocarcinoma. Zhonghua Nei Ke Za Zhi, 44, 573-6.
  40. Xiao J, He X, Wang Z, et al (2014). Serum carbohydrate antigen 19-9 and prognosis of patients with gastric cancer. Tumour Biol, 35, 1331-4. https://doi.org/10.1007/s13277-013-1177-1
  41. Ychou M, Duffour J, Kramar A, et al (2000). Clinical significance and prognostic value of CA72-4 compared with CEA and CA19-9 in patients with gastric cancer. Dis Markers, 16, 105-10. https://doi.org/10.1155/2000/595492
  42. Zheng S, Vuitton L, Sheyhidin I, et al (2010). Northwest China: a place to learn more on oesophageal cancer Part one: behavioural and environmental risk factors. Eur J Gastroenterol Hepatol, 22, 917-25. https://doi.org/10.1097/MEG.0b013e3283313d8b
  43. Zhang YH, Li Y, Chen C, et al (2009). Carcinoembryonic antigen level is related to tumor invasion into the serosa of the stomach: study on 166 cases and suggestion for new therapy. Hepatogastroenterol, 56, 1750-4.

Cited by

  1. Translational progress on tumor biomarkers vol.6, pp.6, 2015, https://doi.org/10.1111/1759-7714.12294
  2. CdSe/ZnS Quantum Dot-Labeled Lateral Flow Strips for Rapid and Quantitative Detection of Gastric Cancer Carbohydrate Antigen 72-4 vol.11, pp.1, 2016, https://doi.org/10.1186/s11671-016-1355-3
  3. Prognostic value of serum tumor abnormal protein in gastric cancer patients vol.5, pp.1, 2016, https://doi.org/10.3892/mco.2016.877