title: Tumor markers for diagnosis, monitoring of recurrence and prognosis in patients with upper gastrointestinal tract cancer.
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.
authors.affiliation: Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital, Shanxi Province, China E-mail : 2912972872@qq.com.
authors.forename: Jie-Xian
authors.initials: JX
authors.lastname: Jing
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiao-Qin
authors.initials: XQ
authors.lastname: Xu
authors.forename: Ting
authors.initials: T
authors.lastname: Sun
authors.forename: Bao-Guo
authors.initials: BG
authors.lastname: Tian
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Du
authors.forename: Xian-Wen
authors.initials: XW
authors.lastname: Zhao
authors.forename: Cun-Zhi
authors.initials: CZ
authors.lastname: Han
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D004938:Esophageal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D010455:Peptides / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D015843:Serpins / Q000097:blood; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D019396:Tissue Polypeptide Antigen / Q000097:blood; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000951:Antigens, Neoplasm; D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; C074601:CA 242 antigen; D018395:CA-19-9 Antigen; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen; D010455:Peptides; D015843:Serpins; D019396:Tissue Polypeptide Antigen; D000509:alpha-Fetoproteins; C051072:squamous cell carcinoma-related antigen; C089984:tissue polypeptide specific antigen