• Journal of Gastric Cancer
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• 제4권4호
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• pp.235-241
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• 2004

목적: 위암의 혈청 종양표지자인 CEA, CA 19.9, CA 72-4가 위암의 수술 전 평가 및 수술 후 재발 감시에 있어서 유용성이 있는지의 여부를 알아보기 위하여 본 연구를 시행하였다. 대상 및 방법: 1995년부터 2000년까지 위암으로 근치적 위절제술을 시행 받은 환자 중 수술 전, 수술 후 2주 그리고 6개월 간격의 추적 관찰 기간 동안 혈청 CEA, CA 19-9, CA 72-4 검사가 시행되었던 환자 255명을 대상으로 후향적 연구를 시행하였다. 종양표지자의 정상 참고치는 CEA의 경우 5 ng/ml, CA 19-9의 경우 36 U/ml, CA 72-4의 경우 4 U/ml로 하였다. 병기는 UICC TNM 병기분류법 제 5판에 준하여 분류하였다. 결과: 각 종양표지자의 수술 전 양성률은 CEA $10.5\%$, CA 19-9 $9.7\%$, CA 72-4 $12.4\%$였고, 세 종양표지자 모두 근치수술 후 혈청치가 감소하였다. CEA가 종양크기와 통계적인 연관성이 없는 것을 제외하고, 세 종양표지자의 수술 전 혈청치는 종양침윤깊이, 종양크기, 림프절 전이, 병기 그리고 재발과 의의있는 연관성이 있었다. 재발 환자에 있어서 종양표지자의 민감도는 CEA $43.3\%$, CA 19-9 $41.8\%$, CA 72-4 $50.0\%$였고, 특이도는 CEA $85.1\%$,CA 19-9 $96.8\%$, CA 72-4 $87.8\%$였다. 결론: CEA,CA19-9, CA 72-4의 수술 전 혈청치는 낮은 양성률 때문에 위암의 초기 진단에 유용성이 낮다. 그렇지만 수술 전 혈청치의 양성률이 종양침윤깊이, 림프절 전이, 종양크기, 병기, 재발과 연관성이 있고, 또한 수술 후 추적 관찰 중에 측정한 세 종양표지자의 혈청치도 비록 민감도는 낮지만 재발과 통계적으로 의의있는 연관성이 있다는 점을 고려해야한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10267-10272
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• 2015

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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4067-4069
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• 2013

Background: The present study was undertaken to establish any correlation of elevated levels of CA19-9 with tumor stage or grade of urothelial carcinoma. Materials and Methods: This hospital based study was carried out in the Department of Biochemistry of Nepalese Army Institute of Health Sciences between $1^{st}$ July 2012 and $31^{st}$ December 2012. Approval for the study was obtained from the institutional research ethical committee. CA19-9 was assayed with an ELISA reader for all cases and expressed in U/ml with 37U/ml taken as the cut-off upper value for normal. Results: Out of 20 cases enrolled, 15 were of urothelial carcinoma and the remaining 5 were controls. There was marked difference between the mean values of CA19-9 in cases $40.2{\pm}19.3U/ml$ of urothelial carcinoma and controls $7.98{\pm}7.34U/ml$. The number of cases in Ta, TI, T2, T3, T4 stages of urothelial carcinoma were 2, 6, 3, 3, 1 respectively. The percentage rise in CA19-9 was less with low grade tumors (22.2%) when compared with high grade tumors (66.6%) (p value $0.001^*$). The percentage of rise in CA19-9 for muscle invasive tumors was very high when compared to superficial tumors. Similarly, the percentage of rise in CA19-9 for metastatic disease was very high when compared to non-metastatic disease and it was found statistically significant (p value $0.001^*$). Conclusion: Serum CA19-9 levels predicts the prognosis of urothelial carcinoma as it is almost invariably raised in tumors having metastatic spread.

• Journal of Gastric Cancer
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• 제3권2호
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• pp.104-111
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• 2003

Purpose: The prognostic significance of peri-operative serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA)19-9 determination in patients with gastric cancer has been controversial. This study was performed to evaluate the significance of CEA and CA19-9 as clinical predictors of prognosis. Materials and Methods: The correlations between peri-operative serum CEA/CA19-9 levels and clinicopathologic factors were evaluated retrospectively in gastric cancer patients who had undergone curative surgery during the period from January 1995 to December 1998 at the Department of Surgery, Yonsei University College of Medicine. Results: The positive rates for CEA and CA19-9 were $17.9\%$ and $18.4\%$, respectively. The CEA positivity was related to the depth of invasion (P=0.040), lymph-node metastasis (P=0.000), and stage (P=0.001). The CA19-9 positivity was significantly related to the depth of invasion (P=0.000), lymph-node status (P=0.000), and stage (P=0.000). The positive rate of combined assay of pre-operative CEA and CA19-9 was $30.0\%$ There were statistically significant correlations with stage, depth of invasion, or degree of lymphnode metastasis in the combined assay. The survival rates according to the positivity of CEA and to the positivity of CA19-9 were clearly different (P=0.000). Conclusion: It should be stressed that even a simple blood test prior to surgery could be useful in establishing the depth of invasion, the status of lymph-node involvement, and the prognosis. For improved survival, an aggressive lymphadenectomy and adjuvant chemotherapy should be considered for patients with positive levels of pre-operative CA19- 9.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3867-3870
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• 2015

Background: To explore whether combined detection of serum tumor markers (CEA, CA72-4, CA19-9 and TSGF) improve the sensitivity and accuracy in the diagnosis of gastric cancer (GC). Materials and Methods: An automatic chemiluminescence immune analyzer with matched kits were used to determine the levels of serum CEA, CA72-4, CA19-9 and TSGF in 45 patients with gastric cancer (GC group), 40 patients with gastric benign diseases (GBD group) hospitalized in the same period and 30 healthy people undergoing a physical examination. The values of those 4 tumor markers in the diagnosis of gastric cancer was analyzed. Results: The levels of serum CEA, CA72-4, CA19-9 and TSGF of the GC group were higher than those of the GBD group and healthy examined people and the differences were significant (P<0.001). The area under receiver operating characteristic (ROC) curves for single detection of CEA, CA72-4, CA19-9 and TSGF in the diagnosis of GC was 0.833, 0.805, 0.810 and 0.839, respectively. The optimal cutoff values for these 4 indices were 2.36 ng/mL, 3.06 U/mL, 5.72 U/mL and 60.7 U/mL, respectively. With combined detection of tumor markers, the diagnostic power of those 4 indices was best, with an area under the ROC curve of 0.913 (95%CI 0.866~0.985), a sensitivity of 88.9% and a diagnostic accuracy of 90.4%. Conclusions: Combined detection of serum CEA, CA72-4, CA19-9 and TSGF increases the sensitivity and accuracy in diagnosis of GC, so it can be regarded as the important means for early diagnosis.

• Radiation Oncology Journal
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• 제34권2호
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• pp.156-159
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• 2016

Although carbohydrate antigen (CA) 19-9 is a useful tumor marker for pancreatic cancer, it can also become elevated from a variety of benign and malignant conditions. Herein we describe an unusual presentation of elevated CA 19-9 in an asymptomatic patient who had previously undergone adjuvant chemotherapy and radiation therapy for resected early stage pancreatic cancer. The rise in CA 19-9 might be due to delayed radiation-induced inflammation related to previous intra-abdominal radiation therapy with or without radiation recall induced by gemcitabine. After treatment with corticosteroids the CA 19-9 level decreased to normal, and the patient has not developed any evidence of recurrent cancer to date.

• Journal of Gastric Cancer
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• 제14권4호
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• pp.221-228
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• 2014

Purpose: This study aimed to evaluate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels to detect gastric cancer recurrence. Materials and Methods: We retrospectively reviewed 154 patients who developed recurrence within 2 years after curative gastric cancer surgery and analyzed the relationship between postoperative CEA and CA19-9 levels and recurrence. We readjusted the cut-off values to improve the detection of recurrence. Subgroup analysis according to clinicopathologic variables was performed to further investigate the relationship between recurrence and CEA and CA19-9 levels. Results: The sensitivity and specificity for elevated CEA levels to detect recurrence were 40.6% and 89.5%, respectively, and those for CA19-9 were 34.2% and 93.6%, respectively. The sensitivity and specificity for elevation of either tumor marker were 54.3% and 84.0%, respectively; those for elevation of both tumor markers were 19.2% and 98.4%, respectively. By readjusting the cut-off values from 5.0 ng/ml to 5.2 ng/ml for CEA and from 37.00 U/ml to 30.0 U/ml for CA19-9, the sensitivity was increased from 34.2% to 40.2% for CA19-9, while there was no increase in sensitivity for CEA. In subgroup analysis, the sensitivity of CEA was higher in patients with elevated preoperative CEA levels than in patients with normal preoperative CEA levels (86.7% versus 33.7%; P<0.001). Furthermore, the sensitivity of CA19-9 was higher in patients with elevated preoperative CA19-9 levels than in patients with normal preoperative CA19-9 levels (82.61% versus 26.83%; P<0.001). Conclusions: CEA and/or CA19-9 measurement with the readjusted cut-off values allows for more effective detection of gastric cancer recurrence.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3451-3455
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• 2015

Objective: To explore the application of joint detection of serum AFP, CA19-9, CA125 and CEA in identification and diagnosis of cholangiocarcinoma (CC). Materials and Methods: The levels of serum AFP, CA19-9, CA125 and CEA of both 30 patients with CC and 30 patients with hepatocellular carcinoma (HCC) were assessed. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic effects of single and joint detection of those 4 kinds of tumor markers for CC. Results: The levels of serum CA19-9, CA125 and CEA in CC patients were higher than that in HCC patients,whereas that of serum AFP was significantly lower s. The area under ROC curve of single detection of serum AFP, CA19-9, CA125 and CEA were 0.05, 0.86, 0.84 and 0.83, with the optimal cutoff values of 15.4 ng/ml, 125.1 U/ml, 95.7 U/ml and 25.9 ng/ml, correspondingly, and the percentage correct single diagnosis was <79%. With joint detection, the diagnostic effect of combined AFP, CA19-9, CA125 and CEA was the highest, with an area under the ROC curve of 0.94 (95%CI 0.88~0.99). Conclusions: Single detection of serum CA19-9, CA125 and EA is not meaningful. The sensitivity, specificity, the rate of correct diagnosis and the area under ROC curve of joint detection of AFP, CA19-9, CA125 and CEA are highest, indicating that the joint detection of these 4 tumor markers is of great importance in the diagnosis of CC.

• 핵의학기술
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• 제14권2호
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• pp.208-211
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• 2010

현재 본원은 TFB사의 CA19-9 항체가 bead에 코팅되어있는 CA19-9 IRMA 시약을 사용하고있다. 이번에 TFB사에서 새로 개발된 CA19-9 항체가 polystyrene test tube에 코팅된 CA 19-9 IRMA 시약이 기존 TFB사의 bead를 사용하는 시약을 대체하여 사용할 수 있는지 시약의 성능을 평가하였다. 본원과 서울대학교병원 환자 56명의 검체를 대상으로 하여 TFB사의 기존 bead 방법을 사용한 시약과 새로 개발된 coated tube를 사용한 시약을 비교하여 상관계수와 회귀식을 구하고 coated tube를 사용한 시약의 정밀도, 회수율, 직선성, 민감도, Hook effect 를 확인하였다. 저, 중, 고역가 검체의 검사내 정밀도는 4.1%, 4.0%, 4.2%이고 검사간 정밀도는 7.6%, 4.3%, 7.8%이며 회수율은 모두 $100{\pm}10%$이다. 직선성은 우수하였고 분석적민감도는 0.3U/mL이었으며 9,020,000 U/mL 농도에서는 Hook effect가 나타나지 않았다. 또한 TFB사의 기존 bead를 사용한 방법과 비교하여 상관관계를 분석한 결과, y=0.9185x-0.953, 상관계수 $R^2$=0.9779이었다. 이번 연구를 통해 본원은 TFB사에서 새로 개발된 coated tube CA19-9 IRMA 시약이 검사 시간과 검사 과정에서 간편화되고 검사시 자동화기기를 사용할 수 있으며 기존 bead를 사용한 시약에 대체하여 사용할 수 있다고 판단하였다.

• 대한두경부종양학회지
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• 제17권2호
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• pp.148-154
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• 2001

Objectives: This study was designed to investigate the significance of serum SCC antigen, CA 19-9, CA 125 level and DNA microsatellite alterations (MSA) as prognostic factors and indicators for recurrences in the pre-treatment and post-treatment state, respectively in head and neck cancer patients. Materials and Methods: 120 patients who received curative treatment for head and neck cancer from 1995 to 2000 were followed up successfully, and were analyzed retrospectively. Thirty healthy subjects served as normal controls. Serum SCC Ag levels were measured by microparticle enzyme immunoassay technique via IMX SCC assay, CA 19-9 levels were measured by CA 19-9 RIA test kit, and CA 125 levels were measured by CA 125 IRMA kit. MSA were identified after PCR amplification. Heterozygosity was considered lost if the ratio of one allele was significantly decreased (>50%) in serum DNA compared with normal DNA from lymphocytes. Results: Preoperative tumor markers were higher in cancer patients than control, but not significant. Postoperative SCC Ag levels were lower than preoperative levels. The SCC Ag levels were remained low in no evidence of disease (NED) group, but increased in locoregional recurrence and distant metastasis group. CA 19-9 and CA 125 levels showed no correlation between levels and recurrences and were not decreased significantly after primary tumor removal. MSA were detected in five out of 21 cases, and highly detected in distant metastasis group. Conclusion: SCC Ag seems to be a helpful serum tumor marker for early detection of recurrence and distant metastasis of head and neck cancer after curative treatment. But, CA 19-9 and CA 125 were not reliable markers for head and neck tumors. MSA were not statistically significant because of the small number of study group. However they may be helpful for screening serum molecular markers for early detection of distant metastasis of head and neck cancers.