title: CA72-4 combined with CEA, CA125 and CAl9-9 improves the sensitivity for the early diagnosis of gastric cancer.
abstract: OBJECTIVE
  To determine whether the combination of tumor markers (CA72-4, CA125, CA19-9 and CEA) could increase the sensitivity and accuracy for in the diagnosis of gastric cancer (GC).
  
  
  METHODS
  This study is a retrospective analysis. A total of 426 patients, including 106 patients with GC, 149 patients with benign gastric diseases and 171 healthy people, who visited Zhejiang Xiaoshan Hospital from January 2011 to December 2013, were measured by serum markers, including CA72-4, CA125, CA19-9 and CEA. Statistical analyses including area under curve (AUC) of receiver operating characteristic (ROC) curve, and logistic regression analysis, were performed to evaluate the diagnostic value of these markers on GC.
  
  
  RESULTS
  Serum levels of CA72-4, CEA, CA125 and CA19-9 were higher in the GC group than those in the benign gastric disease group and the healthy control group (P<0.005). The sensitivities of CA72-4, CEA, CA125 and CA19-9 at the recommended cut-off level for all patients were 33.0%, 25.5%, 31.1% and 38.7%, respectively. However, when all four markers were used in combination the sensitivity increased to 66.0%. But by using an optimal cut-off value, the sensitivities of all four markers for the diagnosis of GC were improved. Especially the sensitivity of CEA increased to 73.6% and the sensitivity of the combination of the tumor markers increased to 75.5%. The age and gender had no effects on the diagnostic value of these markers.
  
  
  CONCLUSIONS
  With the help of optimal cut-off values based on ROC curve and logistic regression analysis, the combination of these markers could improve the sensitivity for the diagnosis of GC based on common serum tumor markers.
authors.affiliation: Department of Clinical laboratory Centre of Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang 311202, China. Electronic address: yangaiping@zjxsh.com.
authors.forename: Ai-Ping
authors.initials: AP
authors.lastname: Yang
authors.affiliation: Department of Clinical laboratory Centre of Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang 311202, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Clinical laboratory Centre of Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang 311202, China.
authors.forename: He-Yue
authors.initials: HY
authors.lastname: Lei
authors.affiliation: Department of Clinical laboratory Centre of Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang 311202, China.
authors.forename: Qun-Wei
authors.initials: QW
authors.lastname: Zhang
authors.affiliation: Department of Clinical laboratory Centre of Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang 311202, China.
authors.forename: Long
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Clinical laboratory Centre of Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang 311202, China.
authors.forename: Guo-Hui
authors.initials: GH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; 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; D055088:Early Detection of Cancer / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis; D055815:Young Adult
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins
keywords: CA125; CA19-9; CA72-4; CEA; Gastric cancer; Tumor markers