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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

Upper gastrointestinal tract cancer;tumor markers;diagnosis;monitoring;prognosis

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