ABSTRACT
Background: Carbohydrate antigen 72-4 (CA72-4) is generally recognized as a tumor marker of digestive system. However, elevated serum CA72-4 level is also evident in many benign diseases and healthy subjects, and its sensitivity in diagnosing malignant tumor is quite poor. Aims: To reassess the value of CA72-4 in tumor screening and diagnosis. Methods: Three cohorts were established in this study. Inpatients who underwent a serum CA72-4 measurement and had a definite final diagnosis were included into Cohort 1 (retrospective study). Inpatients with elevated serum CA72-4 level who had not been diagnosed as malignant tumor before admission were included into Cohort 2 (retrospective study). Individuals who underwent a serum CA72-4 measurement and willing to take a follow-up for at least 2 years were included into Cohort 3 (prospective study). Malignancies had been preliminarily excluded in all individuals in Cohort 3 before enrollment. Results: Among the 2 173 patients recruited in Cohort 1, the prevalence of positive serum CA72-4 was significantly higher in patients with malignancies than those without (16.4% vs. 7.4%, P<0.05). The sensitivity and specificity of CA72-4 for diagnosis of malignant tumor were 36.5% and 76.2%, respectively, at the cut-off value (2.955 U/mL) identified by ROC curve analysis. Among the 1 807 patients recruited in Cohort 2, most of the participants (76.5%) did not have malignancies. Serum CA72-4 level was associated with the histological classification, tumor differentiation and TNM staging of malignancies (P<0.05). Among the 376 individuals who underwent a follow-up for no less than 2 years in Cohort 3, elevated serum CA72-4 level did not increase the risk of malignant tumor (OR=1.268, 95% CI: 0.283-5.687). Conclusions: CA72-4 is not a sensitive marker for tumor screening, its value as an item in physical examination should be re-evaluated. In patients who had positive serum CA72-4 and malignant tumor was ruled out in initial examination, the necessity of long-term follow-up of serum CA72-4 needs to be discussed.
ABSTRACT
Objective To compare and analyze the changes of CEA,CA19-9,CA72-4 in different pathologictypes of gastric cancer.Methods 93 patients with gastric cancer were divided into different groups according to the histological types,pathologic types and TNM staging.The levels of CEA,CA19-9,CA72-4 of the patients were measured,then the results were compared and analyzed.Results The level of serum tumor marker of the moderately differentiated group was obviously higher than that of well-differentiated group(P ＜ 0.05),while the level of serum tumor marker of the poorly differentiated group was obviously higher than that of moderately differentiated group (P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between the well-differentiated group,moderately differentiatedgroup and poorly differentiated group were statistically significant(F =61.433,57.882,125.547,all P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between patients of TMN Ⅰ stage,TMN Ⅱ stage,TMN Ⅲ stage,TMN Ⅳstage were statistically significant(F =189.624,95.236,80.342,all P ＜ 0.05).The difference of serum tumor marker between different histological groups was not statistically significant (all P ＞ 0.05).Conclusion The concentration of serum CEA,CA19-9,CA72-4 will be higher if the gastric tumor is poorly differentiated or invades deeply,but the concentration of serum tumor has nothing to do with the histological types of the tumor.