title: Combined use of AFP, CEA, CA125 and CAl9-9 improves the sensitivity for the diagnosis of gastric cancer.
abstract: BACKGROUND
  The detection of serum tumor marker becomes a common method for screening tumors. However, this method has not been widely used for routine gastric cancer screening. In this study we aimed to determine whether the combined use of tumor markers may increase the sensitivity for the diagnosis of gastric cancer.
  
  
  METHODS
  Serum AFP, CEA, CA125 and CA19-9 levels were measured in 149 patients with gastric cancer, 111 patients with benign gastric diseases and 124 healthy people, who visited the First Affiliated Hospital of Nanchang University from May 2011 to May 2012. Statistical analysis including receiver operating characteristic (ROC) curve, the area under the curve (AUC), and logistic regression analysis was performed to evaluate the diagnostic value of these markers on gastric cancer.
  
  
  RESULTS
  Serum levels of CEA, CA125, and CA19-9 in gastric cancer group were higher than that in the benign gastric disease group and the healthy control group (P <0.005). The sensitivity of AFP, CEA, CA125 and CA19-9 in the diagnosis of gastric cancer was 4.7-20.8% individually, and increased to 40.3% in combination. By using optimal cut-off value, the sensitivity of CEA, CA125, and CA19-9 for the diagnosis of gastric cancer was improved. Especially, the sensitivity of CEA increased to 58.4% and the sensitivity of combined use of four markers increased to 69.1%. The age and gender had no effects on the diagnostic value of these markers.
  
  
  CONCLUSIONS
  The determination and application of optimal cut-off values based on ROC curve and logistic regression analysis could improve the diagnosis of gastric cancer based on common tumor markers.
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University; Jiangxi Institute of Gastroenterology & Hepatology, Nanchang, Jiangxi, 330006, China.
authors.forename: Chao-Zhu
authors.initials: CZ
authors.lastname: He
authors.forename: Kun-He
authors.initials: KH
authors.lastname: Zhang
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Hong
authors.forename: Nong-Hua
authors.initials: NH
authors.lastname: Lv
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D012372:ROC Curve; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis*; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D000509:alpha-Fetoproteins