Tumor markers for diagnosis, monitoring of recurrence and prognosis in patients with upper gastrointestinal tract cancer

Asian Pac J Cancer Prev. 2014;15(23):10267-72. doi: 10.7314/apjcp.2014.15.23.10267.

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.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Neoplasm / blood
  • Antigens, Tumor-Associated, Carbohydrate / blood
  • Biomarkers, Tumor / blood*
  • CA-19-9 Antigen / blood
  • Carcinoembryonic Antigen / blood
  • Carcinoma, Squamous Cell / blood
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / surgery
  • Cohort Studies
  • Enzyme-Linked Immunosorbent Assay
  • Esophageal Neoplasms / blood
  • Esophageal Neoplasms / diagnosis*
  • Esophageal Neoplasms / surgery
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnosis*
  • Peptides / blood
  • Prognosis
  • Prospective Studies
  • Sensitivity and Specificity
  • Serpins / blood
  • Stomach Neoplasms / blood
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / surgery
  • Tissue Polypeptide Antigen / blood
  • alpha-Fetoproteins / metabolism

Substances

  • Antigens, Neoplasm
  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor
  • CA 242 antigen
  • CA-19-9 Antigen
  • CA-72-4 antigen
  • Carcinoembryonic Antigen
  • Peptides
  • Serpins
  • Tissue Polypeptide Antigen
  • alpha-Fetoproteins
  • squamous cell carcinoma-related antigen
  • tissue polypeptide specific antigen