Significance Of Serum Tumor Markers Research Articles

Prognostic significance of serum tumor markers in various pathologic subtypes of gastric cancer

PurposeThis study aimed to assess the utility of 6 serum tumor markers in prognosis between gastric adenocarcinoma and gastric signet ring cell carcinoma (SRCC). MethodsA cohort of 3131 cases of gastric adenocarcinoma and 275 cases of gastric SRCC was assembled. The serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125, alpha fetoprotein (AFP), carbohydrate antigen 242 (CA242), and carbohydrate antigen 724 (CA724) were measured in all cases. The study analyzed the association between the levels of these 6 tumor markers and the prognosis of gastric adenocarcinoma and SRCC. ResultsThe study revealed that gastric SRCC exhibited lower concentrations of CEA (P < .001) and CA19-9 (P = .002), along with reduced positive rates of CEA (P = .041), CA19-9 (P = .003), AFP (P < .001), and CA242 (P = .006), while displaying higher positive rates of CA724 (P = .024) than gastric adenocarcinoma. Nevertheless, the receiver operating characteristic curve demonstrated that serum tumor markers did not hold clinical significance in differentiating between gastric adenocarcinoma and SRCC. Survival analysis substantiated that the combined criteria of serum tumor markers stood as an independent risk factor for both gastric adenocarcinoma and SRCC. Notably, the nomogram indicated that serum tumor markers exerted a more substantial influence on the prognosis of gastric adenocarcinoma than on gastric SRCC. ConclusionThe study concluded that the combined criteria of serum tumor markers emerge as independent risk factors for both subtypes of gastric cancer. Furthermore, this combined approach exhibited enhanced efficacy in prognosticating the outcome of gastric adenocarcinoma compared with gastric SRCC.

The Significance of Serum Tumor Markers CEA, Ca 19-9, Ca 125, Ca 15-3, and AFP in Patients Scheduled for Orthotopic Liver Transplantation: Do Elevated Levels Really Mean Malignancy?

Preparation of the patients for liver transplantation is a meticulous process and includes evaluation of tumor markers to rule out occult malignancy. The present study evaluated the significance of serum tumor markers in patients bound for liver transplantation due to viral and other etiologies of liver failure. Three hundred eighty-one patients who underwent liver transplantation were included in the study. Demographic data, model for end stage liver disease (MELD) scores, and serum tumor marker levels were prospectively collected. AFP levels were significantly higher in viral etiologies when compared to other etiologies (p < 0.05). Ca 19-9 was significantly higher in viral etiologies (p < 0.05). Among the viral etiologies, HCV-related liver failure had higher carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (Ca 19-9) levels (p < 0.05). A correlation was found between increasing MELD scores and serum levels of tumor markers (p < 0.05). Tumor markers such as AFP, CEA, Ca 125, and Ca 19-9 can be elevated in end stage liver disease. Their levels vary according to etiology and severity of disease. The diagnostic capabilities of these markers are reduced in end stage liver disease setting but they contribute to the evaluation of the pathophysiology of chronic liver disease. Transplantation can be performed safely in cases with high tumor marker levels provided that any occult malignancy is ruled out by means of imaging and endoscopic techniques. Tumor markers can guide the physician in determining the severity of liver cirrhosis, and further studies are needed to validate such a relationship.

Impact of Preoperative Serum Tumor Markers in Patients with Lung Squamous Cell Carcinoma

Background: Several previous researchers have investigated the prognostic value of serum tumor markers, especially carcinoembryonic antigen (CEA). Only a limited number of studies reported the usefulness of serum tumor markers for lung squamous cell carcinoma (SQ). We aimed to examine the significance of serum tumor markers for lung SQ. Methods: Eighty-five lung SQ patients who underwent surgery and followed more than 5-year were included. The ratios of 5-year survivors to all patients in groups with several clinicopathologic factors, including tumor markers, were compared. We also compared the clinicopathologic factors between central type and peripheral type SQ. Results: The majority of patients were male gender and current/ former smokers. Age, pN status, cytokeratin-19 fragment (CYFRA 21-1), squamous cell carcinoma antigen (SCC), and comorbid interstitial pneumonia (IP) were associated with the ratio of 5-year survivors significantly. When patients were compared based on tumor location, high p-stage and CYFRA 21-1 were related to central type SQ. Conclusion: Both SCC and CYFRA 21-1 appeared to be useful prognostic markers for patients with lung SQ. Furthermore, CYFRA 21-1 was related to central type SQ.

Clinical significance of serum tumor markers for advanced gastric cancer with the first-line chemotherapy.

BackgroundTumor markers play an important role in the diagnosis, monitoring and prognostic prediction of cancers. But the predictive value of serum tumor markers in gastric cancer is still unclear.MethodsIn this study, we detected serum levels of tumor markers to evaluate their relation to treatment response and prognosis in patients with unresectable advanced or metastatic gastric cancer.ResultsWe collected the clinical data of 109 patients with unresectable advanced or metastatic gastric cancer who had received the first-line chemotherapy in Peking University Cancer Hospital from July 2013 to May 2015, and collected the value of serum carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 72.4 (CA72.4) and carbohydrate antigen 125 (CA125) before and after chemotherapy. At diagnosis, the positive rates of CEA, CA199, CA72.4 and CA125 were 46.8%, 40.2%, 53.5% and 35.0%, respectively. And the positive rate of combined detection of the four markers was 87.2%. Although patients with prechemotherapy CA199 ≥80 U/mL (92.3% vs. 68.5%, P=0.016) or CA72.4 ≥20 U/mL (91.4% vs. 62.5%, P=0.003) had higher clinical benefit rate after chemotherapy, they showed poorer prognosis (P=0.023 and P=0.006, respectively). CA72.4 ≥20 U/mL was an independent unfavorable prognostic factor (Hazard Ratio 4.84; 95% confidence interval: 1.910–12.262; P=0.001). In patients with increased levels of tumor markers before treatment, the levels of tumor markers decreased after chemotherapy, especially in those with clinical benefit (CEA, CA72.4 reached statistical significance, P=0.013 and P=0.029, respectively). A decrease of CEA ≥35%, CA199 ≥30%, or CA72.4 ≥40% after chemotherapy had positive prediction value for the response to chemotherapy (P=0.016, P=0.029, and P=0.008, respectively).ConclusionsThe results showed that both high pre-chemotherapy serum levels of tumor markers (CA199 ≥80 U/mL or CA72.4 ≥20 U/mL) and a substantial decrease in tumor markers after chemotherapy (CEA ≥35%, CA199 ≥30%, or CA72.4 ≥40%) could predict a higher clinical benefit rate in patients with unresectable advanced or metastatic gastric cancer. However, this advantage in short-term response to chemotherapy failed to convert into prolonged survival benefits.

Increased CYFRA 21-1, CEA and NSE are Prognostic of Poor Outcome for Locally Advanced Squamous Cell Carcinoma in Lung: A Nomogram and Recursive Partitioning Risk Stratification Analysis

OBJECTIVES: This study aimed to: (1) assess the prognostic significance of serum tumor markers in locally advanced squamous cell carcinoma in lung (LA-SCCL); (2) generate a nomogram to predict the overall survival (OS) and (3) identify a prognostic stratification to assist the therapeutic decision-making. METHODS: LA-SCCL patients receiving definitive radiotherapy and baseline tumor marker measurement were eligible for this retrospective study. Cox proportional hazards regression was used to determine independent factors associated with various survival indexes and a nomogram was created to estimate the 5-year OS probability for individual patient. The identified prognostic factors were recruited into a recursive partitioning analysis (RPA) for OS to stratify patients with distinct outcome. RESULTS: A total of 224 patients were eligible for analysis. Increased cytokeratin-19 fragment (CYFRA 21-1) was independently associated with inferior OS, progression free survival (PFS) and a borderline decreased local-regional progression free survival (LRPFS). Elevated carcino-embryonic antigen (CEA) served as an unfavorable determinant for OS and increased neuron-specific enolase (NSE) was predictive of poor distant metastasis free survival (DMFS). A nomogram integrating KPS, TNM stage, CEA and CYFRA 21-1 was created, resulting in a c-index of 0.62. RPA identified 4 prognostic classifications, with median OS of 27.6, 19.9, 17.3 and 10.9 months for low, intermediate, high and very-high risk groups, respectively. CONCLUSIONS: Baseline tumor marker panel including CYFRA 21-1, CEA and NSE can be prognostic of outcome for LA-SCCL receiving definitive radiotherapy. The RPA identified four prognostic subgroups, which could assist personalized therapy and clinical trial design in LA-SCCL.

P17. Prognostic significance of serum tumor markers in patients with advanced-stage NSCLC treated with pemetrexed-based chemotherapy

Background Tumor biomarkers represent an effective tool for diagnostics and follow-up monitoring of patients with non-small cell lung cancer (NSCLC). We focused on predictive and prognostic role of seven following tumor biomarkers: carcinoembryonic antigen (CEA), cytokeratin-19 fragments (CYFRA 21-1), MonoTotal, neuron-specific enolase (NSE), chromogranin A, thymidine kinase (TK) and squamous cell carcinoma antigen (SCCA) in patients with advanced-stage NSCLC treated with pemetrexed-based chemotherapy.

Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association

The aim of this review was to evaluate the clinical significance of serum tumor markers, particularly CEA, CA19-9, and CA72-4, in patients with gastric cancer. A systematic literature search was performed using PubMed/MEDLINE with the keywords "gastric cancer" and "tumor marker," to select 4,925 relevant reports published before the end of November 2012. A total of 187 publications contained data for CEA and CA19-9, and 19 publications contained data related to all three tumor markers. The positive rates were 21.1 % for CEA, 27.8 % for CA19-9, and 30.0 % for CA72-4. These three markers were significantly associated with tumor stage and patient survival. Serum markers are not useful for early cancer, but they are useful for detecting recurrence and distant metastasis, predicting patient survival, and monitoring after surgery. Tumor marker monitoring may be useful for patients after surgery because the positive conversion of tumor markers usually occurs 2-3 months before imaging abnormalities. Among other tumor markers, alpha-fetoprotein (AFP) is useful for detecting and predicting liver metastases. Moreover, CA125 and sialyl Tn antigens (STN) are useful for detecting peritoneal metastases. Although no prospective trial has yet been completed to evaluate the clinical significance of these serum markers, this literature survey suggests that combinations of CEA, CA19-9, and CA72-4 are the most effective ways for staging before surgery or chemotherapy. In particular, monitoring tumor markers that were elevated before surgery or chemotherapy could be useful for detection of recurrence or evaluation of the response.

Abstract 3623: Clinical significance of serum tumor markers in patients with esophageal cancer

Abstract Background: Esophageal cancer is still a disease with a high degree of fatality despite resent advances in surgical techniques and various therapies. Several serum tumor markers have been applied to diagnose and to follow-up in patients with esophageal cancer in clinical practice in Japan. The aim of this study was to investigate the diagnostic and prognostic significance of various serum tumor markers in patients with esophageal cancer. Methods: Eighty one patients with esophageal cancer were recruited for this study. Serum level of tumor markers, squamous cell carcinoma antigen(SCC-Ag), p53 antibody(p53-Ab) carcinoembryonic antigen(CEA), and CYFRA 21-1, were measured in subjects before treatment. The results of these tumor markers were compared with the clinicopathological findings of the subjects. Results: The positive rates of SCC-Ag, p53-Ab, CEA and CYFRA 21-1 were 44%, 34%, 17%, and 16% patients with esophageal cancer, respectively. SCC-Ag and p53-Ab showed positive with a relatively high frequency in cases of early stage esophageal cancer or superficial invasion, while CEA and CYFRA 21-1 could rarely be detected in such cases. Positive for SCC-Ag was significantly higher in patients with tumor invading into or through the musclaris propria than the patients within the submucosal layer. Substantially, the positive rate of SCC-Ag was associated with an advanced stage of disease. Values of p53-Ab in serum virtually demonstrated gradual decrease after treatment, not rapid depletion. All negative cases for p53-Ab before treatment showed negative at any point of treatment or follow-up on a consistent basis. CYFRA 21-1 showed positive in cases with distant metastasis. Conclusion: Each tumor marker for esophageal cancer presented different features in a clinicopathological analysis. The use of several combination of serum tumor markers seems to be most important for the detection and follow-up for of esophageal cancer at present. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3623. doi:1538-7445.AM2012-3623

Clinical significance of serum tumor markers in patients with lung cancer

Objective To investigate the serum tumor markers level of carcinoembryonic antigen(CEA) ,cytokeratin fragment antigen21-1 (CYFRA21-1),neuron specific enolase (NSE) in patients with lung cancer, and the change after chemotherapy on them. Methods Radioimmunoassay was applied to detect the levels of CEA, CYFRA21-1 ,NSE in 45 patients with advanced NSCLC before and after chemotherapy,and the tumor markers were also detected in 20 patients with SCLC and 20 patients with benign lung diseases of control groups. Results The levels of CEA, CYFRA21-1, NSE in lung cancer group before chemotherapy were much higher than benign group, but there was no difference of CYFRA21-1 between the SCLC group and benign group. The same result of NSE was found between NSCLC and benign group(P ＞0. 05). The value of NSE was lower in the patients with SCLC after chemotherapy than before(P ＜0. 01 ). The level of CYFRA21-1 was lower in squamous carcinoma than before( P ＜0. 01 ). But in the adenocarcinoma group only NSE's level was lower after chemotherapy( P ＞0. 05) ,there were no differences in CEA and CYFRA21-1 ( P ＞ 0. 05 ). Conclusion The levels of the three tumor markers rise obviously in advanced NSCLC and decrease after chemotherapy. The differences were significant with NSE in SCLC and CYFRA21-1 in squamous cell carcinoma and CEA in adenocarcinoma. The levels of serum CEA,CYFRA21-1 and NSE could be a tumor marker in progressive lung cancer. And the decrease of the levels could be used to evaluate the chemotherapeutic response respectively in different pathologic types of lung cancer. Key words: Lung neoplasms ; Tumor markers, biological

The clinical significance of serum tumor markers in the diagnosis of brest cancer

Objective To explore the clinical significance of combined detection of serum CA153,TPS,CA125 in the diagnosis of breast cancer. Methods Technique of electrochem ilum inescence immunoassay was used to mesure serum CA153,TPS and CA125 levels. Results The levels and the positive rates of three kinds of markers in breast cancer patients were significantly higher than those of mammary benign patients and normal controls (P ＜ 0. 01) , The diagnostic sensitivity and accuracy of combined detection were higher than that of single assay. Conclusion The combined detection of serum CA153,TPS, CA125 levels has important clinical significance in the diagnosis of breast cancer. Key words: Breast cancer; Serum; Tumor marker; Combined detection; Diagnosis

Significance of serum tumor markers monitoring in carcinomas of unknown primary site

Unknown primary tumors represent a heterogeneous group of malignancies that are indicative of ominous prognosis. Cancer of unknown primary site (CUP) is defined as the lack of any detectable primary site after full evaluation, and accounts for approximately 3-5% of all newly diagnosed patients with malignancies. The aim of this report was to present the prognostic and predictive value of 8 serum tumor markers in this group of patients. The study involved 63 patients. On histological examination, all the patients were presented with metastatic tumors whose primary site (origin) could not be detected with noninvasive diagnostic techniques. Following the routine light microscopy, all histological findings were classified into one of the following three groups: plano-cellular carcinoma--8 patients; adenocarcinoma--33 patients; unclassifiable (undifferentiated) carcinoma--22 patients. In all the cases we evaluated 8 serum tumor markers: alpha-fetoproteins (AFP), chronic gonadotrophin beta submit, human (beta-HCG), neuron specific enolase (NSE), marker of malignant ovarian tumors (CA 125), prostate-specific antigene (PSA), marker of malignant brest tumor (CA 15-3), marker of malignant pancreas tumor and gastrointestinal tumor (Ca 19-9), carcinoembryonic antigen (CEA) at the time of diagnosis. The patients on chemotherapy had the markers determined after the third and sixth chemocycle, i.e. at the time of illness progression observation, if present. The patients responding to chemotherapy with complete response (CR), partial response (PR) or stable disease (SD) had the markers determined after three-month periods until the time of relapse or progression. Chemotherapy was applied in 32 patients (20 females and 12 males), aged 29-70 years, who met the inclusion criteria. The following chemotherapy regimen was used: doxorubicin 50 mg/m2 (day 1), cisplatin 60 mg/m2 (day 1), and etoposide 120 mg/m2 (days 1-3). The period between two chemotherapy cycles was three weeks, and maximum five weeks in the case of prolonged hematological toxicity. Most commonly elevated were NSE values (82.54%), while AFP values were least commonly elevated (11.11%). Average survival time was 17.89 months (95% CI 12.96; 22.83). The probability of 24 months' survival was 0.228. The group of 32 patients treated with chemotherapy had 12 (37.5%) fatal outcomes in the observed period (72 months). Average survival time was 26.6 months (95% CI 19.5; 33.7). Average tumor marker values before and after the chemotherapy were significantly lower for NSE and CA 125. Survival was significantly better in cases of NSE and CA 125 decrease of more than 20%. Increased values of serum tumor markers are very often in CUP. The tumors show nonspecific overexpression of tumor markers. The NSE and CA 125 levels show good correlation with response to the given chemotherapy. However, a routine evaluation of commonly used serum tumor markers has not been proven of any prognostic and predictive assistance.

Significance of serum tumor markers in monitoring advanced breast cancer patients treated with systemic therapy: A prospective study

The significance of serum tumor markers in monitoring advanced breast cancer patients is still controversial. To clarify this issue, the Tumor Marker Study Group of the Japanese Breast Cancer Society conducted a prospective study. Patients with advanced breast cancer who were treated with systemic therapy between January and December 2002 were recruited from five collaborative institutes in Japan. The patients were monitored every four weeks using three serum tumor markers, CEA, CA 15-3 and NCC-ST-439 during the therapy. Findings from 108 eligible patients were analyzed. The pretreatment positivity rates were 51.9% for CEA, 50% for CA 15-3, and 34.3% for NCC-ST-439. The changes in each marker level at 8 and 12 weeks but not at 4 weeks after the start of therapy seemed to correlate with the response to therapy in pretreatment marker-positive patients but not in negative patients. The Cox proportional hazard model revealed a greater than 20% reduction in CEA, CA 15-3 or NCC-ST-439 levels at 4, 8 and/or 12 weeks after the start of therapy to be an independent predictive factor for longer time-to-progression (TTP) in pretreatment marker-positive patients. This prospective study supported the findings obtained from our previous retrospective study that in pretreatment marker-positive patients 1) the changes in serum tumor marker levels after the start of therapy correlate with the response to therapy; and 2) a greater than 20% reduction in the tumor marker levels was a favorable predictive factor for TTP during systemic therapy. When the pretreatment serum level of these markers is over the respective cut-off value, sequential measurement of them may be useful for evaluating the efficacy of treatment as well as monitoring the outcome of patients with advanced breast cancer.

Clinical and biological significance of serum tumor markers in adult T-cell leukemia.

As the clinical manifestations of adult T-cell leukemia (ATL) can be quite diverse, useful indicators for the therapy and prognosis are required for the disease. In this review, the clinical and biological significance of serum tumor markers at diagnosis in ATL patients is described. Serum lactic dehydrogenase (S-LDH), serum thymidine kinase (S-TK) and serum parathyroid hormone-related protein (S-PTHrP) at diagnosis of ATL showed a correlation with among leukocyte count, absolute number of abnormal lymphocytes with polymorphic nuclei, platelet count, serum calcium and the length of survival after the initial diagnosis. Serum beta 2-microglobulin (S-beta 2M) correlated with age, platelet count and survival. A statistical correlation existed between these four serum tumor markers. Other serum tumor markers such as immunosuppressive acidic protein (S-IAP), ferritin (S-Ft) and tissue polypeptide antigen (S-TPA) showed no correlation with clinical and histological data in ATL patients.

VARIABILITY OF SERUM TUMOR-ASSOCIATED ANTIGENS AND THEIR SIGNIFICANCE IN CANCER-DIAGNOSIS (REVIEW)

The significance of serum tumor markers in the diagnosis of several of the most widespread types of cancer (lung, gastric, colorectal, breast, endometrial and ovarian) has been reviewed. The high heterogeneity of obtained results demonstrated in this review suggests that none of the present markers can be utilized alone as a significant marker of neoplasia and that only their combined use can give objective information. The role of individual variability of various markers in the detection of different stages of neoplastic transformations has also been revised. It was concluded that none of the markers studied can be absolutely positive without false results, and that objective information regarding early stages of malignancy may be obtained only with a combined analysis utilizing many laboratory methods. A new approach should be developed in oncological diagnostic practice.