• Title/Summary/Keyword: CA19-9

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Preliminary Evaluation of Clinical Utility of CYFRA 21-1, CA 72-4, NSE, CA19-9 and CEA in Stomach Cancer

  • Gwak, Hee Keun;Lee, Jai Hyuen;Park, Seok Gun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4933-4938
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    • 2014
  • Background: Although various tumor markers have been utilized in management of stomach cancer (SC), only a few reports have described relevance of examples such as CYFRA 21-1 and neuron-specific enolase (NSE). The purpose of this study was to evaluate the potential diagnostic performance of carcinoembryonic antigen (CEA), CA 19-9, CA72-4, CYFRA 21-1 and NSE in patients with SC. Materials and Methods: Ninety-six SC patients with pathologic confirmation between 2012 and 2013 were enrolled. Serum levels of five tumor markers were analyzed using a solid-phase immunoradiometric assay. Receiver operating characteristic (ROC) curves were plotted for the five tumor markers to investigate their diagnostic powers and adjusted cutoff values derived from analysis of ROC curves were evaluated to calculate the sensitivity of each for SC with recommended cutoff values. Results: Based on two different cutoff values (recommended and adjusted), CYFRA 21-1 (${\geq}2.0$ and 1.2 ng/ml) had a respective sensitivity of 50% and 78.1%, compared with 8.3% and 18.8% for CEA (${\geq}7.0$ and 3.9 ng/ml), 15.6% and 18.8% for CA 19-9 (${\geq}37$ and 26.7 ng/ml), 28.1% and 9.6% for CA 72-4 (${\geq}4.0$ and 13 ng/ml) and 7.3% and 7.3% for NSE (${\geq}14.7$ and 15.0 ng/ml) in the initial staging of primary SC. The area under the curve (AUC) for CYFRA 21-1, with a value of 0.978 (95% confidence interval, 0.964-0.991) was comparatively the highest. Univariate analysis revealed significant relationships between tumor marker level and lymph node involvement, metastasis and staging with CYFRA 21-1, CA 72-4 and NSE. Conclusions: CYFRA 21-1 was the most sensitive tumor marker and showed the most powerful diagnostic performance among the five SC tumor markers. NSE and CA 72-4 are significantly related to lymph node involvement, metastasis or stage. Further evaluations are warranted to clarify the clinical usefulness and prognostic prediction of these markers in SC.

Analysis of cytosine adenine repeat polymorphism of the IGF-I promoter gene in children with idiopathic short stature (특발성 저신장증 환자에서 IGF-I 프로모터 cytosine-adenine repeat 유전자 다형성의 분석)

  • Moon, Jae Hoon;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.356-363
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    • 2009
  • Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature.

Immunoscintigraphy of Colorectal and Other Gastrointestinal Cancers with Radioactive Monoclonal Antibodies to CEA and CA 19-9 (대장직장암 및 기타 소화기암에서의 단세포군항체를 이용한 방사면역신티그라피의 진단)

  • Jang, Dae-Hwan;Choi, Duck-Joo;Lee, Bum-Woo;Park, Won;Han, Chang-Soon;Kim, Hak-San;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.1
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    • pp.83-92
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    • 1988
  • The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

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A Study on the Comparison of One Step Method and Two Step Method to Improve Reporting of CA 19-9 Results (CA 19-9 결과보고 개선을 위한 One step 방식과 Two step 방식의 비교에 관한 연구)

  • Jae-Seok An;Ji-Na Kim;Kwang-Seo Park;Eun-Bit Joo;Sang-Hyuk Yoon;Yoon-Cheol Kim
    • The Korean Journal of Nuclear Medicine Technology
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    • v.28 no.1
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    • pp.81-87
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    • 2024
  • Purpose: CA 19-9 is the most widely used tumor marker for the diagnosis of digestive system tumor, especially pancreatic and biliary tract cancer. This study was conducted to improve the result value near reference range by comparing the reagents of CA 19-9 one step method and two step method. In addition, it was intended to establish a standard for selecting reagents. Material and Methods: 120 patients who visited the National Cancer Center in 2023 were selected as subjects for this study. The reagents used in the study were CA 19-9 IRMA kits (Shinjin, Korea) and three types of reagents were compared. Two step method reagent that is currently being used (A), one step method reagent (B) and two step method reagent improved by request (C) were compared and regression analysis was performed on their data. And we also performed recovery test, linearity test and hook effect test for each reagent. Result: There were 46 cases of reagent B in which the concentration value was lower than the result measured in reagent A that was previously used, and 77 cases of reagent C. As a result of regression analysis of reagents A, B, and C, the coefficients of determination of reagents A and B, reagents A and C, and reagents B and C were 0.653, 0.577, and 0.875. In the recovery rate test and the linearity test, the results of all reagents were good, and in the hook effect test, reagent B showed a hook effect at a low value. Conclusion: The improved reagent C appears to have been improved based on the concentration value of reagent B, which the manufacturer judged to be more stable at low concentrations. The hook effect in reagent B can be a fatal reason for disqualification when selecting reagents in general patient samples which high-concentration samples appear frequently. The first improved reagent C will be able to be used once it is confirmed that it has more stability for various concentration values.

The Evaluation of Proficiency Test between Radioimmunoassay and Chemiluminescence Immunoassay (방사면역측정법과 화학발광면역측정법간의 숙련도 비교평가)

  • Noh, Gyeong-Woon;Kim, Tae-Hoon;Kim, Ji-Young;Kim, Hyun-Joo;Lee, Ho-Young;Choi, Joon-Young;Lee, Byoeng-Il;Choe, Jae-Gol;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.116-124
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    • 2011
  • Purpose: To establish accurate external quality assurance (EQA) test, cross institutional and modality tests were performed using WHO certificated reference material (CRM) and same pooled patients serum. Materials and Methods: Accuracy and precision were evaluated using CRM and pooled patients' serum for AFP, CEA, PSA, CA 125, CA 19-9, T3, T4, Tg, TSH. To evaluate the accuracy and precision, recover test and coefficient variation were measured. RIA test were performed in major 5 RIA laboratory and EIA (CLIA) test were done in 5 major EIA laboratory. same sample of CRM and pooled serum were delivered to each laboratory. Results: In 2009, mean precision of total tumor marker of RIA was $14.8{\pm}4.2%$ and that of EIA(CLIA) was $19.2{\pm}6.9%$. In 2010, mean precision of 5 tumor marker and T3, T4, Tg, TSH was $13.8{\pm}6.1%$ in RIA and $15.5{\pm}7.7%$ in EIA (CLIA). There was no significant difference between RIA and EIA. In RIA, the coefficient variations (CV) of AFP, CEA, PSA, CA 125, T3, T4, TSH were within 20%. The CV of CA 19-9 was over 20% but there was no significant difference with EIA (CLIA) (p=0.345). In recovery test using CRM, AFP, PSA, T4, TSH showed 92~103% of recovery in RIA. In recovery test using commercial material, CEA, CA 125, CA 19-9 showed relatively lower recovery than CRM but there was no significant difference between RIA and EIA (CLIA). Conclusion: By evaluating the precision and accuracy of each test, EQA test could more accurately measured the quality of each test and performance of laboratory.

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The Decomposition Kinetics of PET Microfiber Fabrics by Saturated CaO/Ethylene glycol Solution (CaO/Ethylene glycol 용액에 의한 Polyester섬유의 분해에 관한 연구)

  • Yoon, Jong Ho;Huh, Man Woo;Kim, Kyung Jae
    • Textile Coloration and Finishing
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    • v.9 no.3
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    • pp.18-26
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    • 1997
  • Polyester microfiber fabrics were decomposed at 100, 110, and 12$0^{\circ}C$ in saturated CaO/ethylene glycol solutions(CaO/EG), and the characteristics of decomposition kinetics were discussed in comparison to those by hot aqueous hydroxide solution(NaOH). The Arrhenius pre-exponential factor(A) was 9.17x $10^{14}$/M $sec^{-1}$and the activation energy($E_{a}$) was 8.19kcal/mol. While the A value was 1.947x $10^{14}$/M $sec^{-1}$ and the ($E_{a}$ value was about 15~19kcal/mol in NaOH-PET decomposition reaction. The much higher A value of the CaO/EG-PET decomposition reaction means that CaO/EG-PET decomposition reaction will occur in a less selective fashion in comparison to the NaOH-PET decomposition reaction. On the other hand, the lower ($E_{a}$) value of the CaO/EG-PET decomposition reaction than that of the NaOH-PET decomposition reaction means that CaO/EG-PET decomposition reaction is less sensitive on the variation of temperature than NaOH-PET decomposition reaction.

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At Which Stage of Gastric Cancer Progression Do Levels of Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Increase? Application in Advanced Gastric Cancer Treatment

  • Han, Eui Soo;Lee, Han Hong;Lee, Jun Suh;Song, Kyo Young;Park, Cho Hyun;Jeon, Hae Myung
    • Journal of Gastric Cancer
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    • v.14 no.2
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    • pp.123-128
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    • 2014
  • Purpose: Since there are no proven tumor markers that reflect the course of gastric cancer, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are commonly used alternatives. However, the degree of progression that corresponds to an increase in these markers, and the values of these markers at different cancer stages, remains unclear. Materials and Methods: This study enrolled 1,733 gastric cancer patients who underwent surgery and whose pre-operative CEA and CA19-9 levels were known. Survival curves and mean values of the two markers were compared according to the degree of cancer progression: serosa-unexposed (SU), serosa-exposed (SE), direct invasion (DI), localized seeding (P1), and extensive seeding (P2). Results: The 5-year overall survival rates at each stage differed significantly, except between DI and P1 patients (17.1% vs. 10.5%, P=0.344). The mean CEA values in SU, SE, DI, P1, and P2 patients were 5.80, 5.48, 13.36, 8.06, and 22.82, respectively. The CA19-9 values for these patients were 49.40, 38.97, 101.67, 73.77, and 98.57, respectively. The increase in CEA in P2 patients was statistically significant (P=0.002), and the increases in CA19-9 in DI and P2 patients were significant (P=0.025, 0.007, respectively). There was a fair correlation between the two markers in P2 patients (r=0.494, P<0.001). Conclusions: CA19-9 can be used to assess DI of gastric cancer into adjacent organs. Both markers are useful for predicting the presence of extensive peritoneal seeding.

Intelligent Diagnosing Method Based on the Conditional Probability for the Pancreatic Cancer Early Detection (췌장암 조기진단을 위한 조건부 확률 기반 지능형 진단 방식)

  • JANG, IK GYU;JUNG, JOONHO;KO, JAE HO;MOON, HYUN SEOK;JO, YUNG HO
    • Journal of Biomedical Engineering Research
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    • v.38 no.5
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    • pp.227-231
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    • 2017
  • Early diagnosis of pancreatic cancer had been considered one of the important barrier for successful therapy since the five year survival rate after treatment of pancreatic cancer was critically low. Nonetheless, patients often miss the golden time of treatment because they rarely visit the hospital until their symptoms are severe. To overcome these problems, a lot of information about the patient's symptoms should be applied as biomarkers for early diagnosis. For this reason, a biomarker for early detection of pancreatic cancer (CA19-9) has been developed as a diagnostic kit. However, since the diagnosis is not accurate enough, pancreatic symptoms (abdominal pain, jaundice, anorexia, diabetes, etc.) and biomarkers (CA19-9) should be considered together. We develop an intelligent diagnostic system that considers CA19-9 and the incidence of pancreatic cancer for pancreatic symptoms that was determined by studying a large number of patient information. It shows a higher accuracy than one using CA19-9 alone. It may increase the survival rate of pancreatic cancer because it can diagnose pancreatic cancer early.