Abstract
BackgroundThe 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.MethodsSerum 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.ResultsSerum 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.ConclusionsThe 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.
Highlights
The detection of serum tumor marker becomes a common method for screening tumors
Positive rates of serum tumor markers in gastric cancer of different clinicopathological features According to the stage, location and histological differentiation of gastric cancer, we subdivided gastric cancer group and calculated positive rates of 4 serum tumor
To exclude the possible effects of age and gender, we got adjusted odds ratio (ORa) after the adjustment of gender and age, and the results showed that carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and cancer antigen 19–9 (CA19-9) levels were positively correlated with the risk of gastric cancer (Table 3)
Summary
The detection of serum tumor marker becomes a common method for screening tumors. 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. The detection of serum tumor marker is simple and easy and becomes a common clinical method for screening tumor. Tumor markers such as alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and cancer antigen 19–9 (CA19-9) have been. We hypothesized that the combined use of tumor markers may avoid the inconsistence and increase the sensitivity for the diagnosis of gastric cancer. In this study we detected the serum levels of tumor markers AFP, CEA, CAl25 and CAl9-9 in 149 patients with gastric cancer, 111 patients with benign gastric diseases and 124 healthy people. Our results showed that the determination of optimal cut-off values of these markers could increase the sensitivity for the diagnosis of gastric cancer
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