Clinical significance of CA125 and CA72-4 in gastric cancer with peritoneal dissemination

Abstract

Background Serum tumor markers have been shown to correlate with the clinical status of patients with advanced gastric cancer. However, the clinical significance of each tumor marker in patients with peritoneal dissemination has not been fully verified. Methods Four serum markers, carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA125, and CA72-4, were periodically measured in 102 patients with peritoneal dissemination who received combination intravenous and intraperitoneal chemotherapy. The initial values at diagnosis and after treatment were analyzed in association with clinicopathological factors, response to chemotherapy, and overall survival. Results The sensitivities of CEA, CA19-9, CA125, and CA72-4 for peritoneal metastasis at the initial diagnosis were 19, 36, 46, and 45%, respectively. The CA125 level was significantly correlated with the degree of peritoneal dissemination and the existence of malignant ascites. Patients with ovarian metastasis showed significantly higher levels of CA72-4. The median survival time of patients with an elevated CA125 level was significantly shorter than that of patients with a normal CA125 level (36.7 vs. 16.6 months, p \ 0.001). Multivariate analysis showed that the degree of peritoneal metastasis and an elevated CA125 level were independent prognostic factors. Normalization of the CA125 level after 3 courses of chemotherapy was correlated with reduced ascites and improved survival.Conclusions Serum CA125 and CA72-4 are clinically useful markers in diagnosis, evaluating the efficacy of chemotherapy, and predicting the prognosis of patients with peritoneal dissemination. From an academic point of view, periodic measurements of these markers are warranted in gastric cancer patients with possible peritoneal dissemination.

Differences and correlation of serum CEA, CA19-9 and CA72-4 in gastric cancer

“…The CA72-4 was identified as a tumor marker for late-stage GC in previous studies. Emoto et al (31) determined that the sensitivity of CA72-4 for the peritoneal metastasis of GC was 45%, which was higher compared with that of CEA and CA19-9. Patients with ovarian metastasis exhibited significantly higher levels of CA72-4 (31).…”

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 serum CA125 levels had high sensitivity (38.6 %), specificity (98.4 %), and diagnostic accuracy (91.5 %). Emoto et al [50] also showed the sensitivities of CA125 for peritoneal metastasis at the initial diagnosis was 46 %. The CA125 level was significantly correlated with the degree of peritoneal dissemination and patient survival [50,55,57].…”

“…Among these 19 articles, 12 articles indicated that the positive rate for CA72-4 was the highest among the three serum markers ( Table 2). The combination with the highest positive rate was CA19-9 and CA72-4 [15,50]. Because the average frequency of these three markers was approximately 10 % at stage I (CEA = 13.7 %, CA19- Clinical utility of tumor markers in gastric cancer 27 9 = 9.0 %, and CA72-4 = 12.0 %), they may not be useful for early cancer screening.…”

“…The overall positive rates for CA72-4 were reported to be 16-70 %, which were generally higher than CEA and CA19-9 [1,12,37,39,42,50]. Elevated CA72-4 was associated with tumor depth [28,37,43], nodal involvement [10,12,20,24,28,34,37,42,43], peritoneal metastases [10,24,34,43], distant metastases [34,43], and stage [9,20,28,34,35,39,42,43].…”

Serum Protein and Genetic Tumor Markers of Gastric Carcinoma

“…Gastroscopy with biopsy is currently an efficient method for the diagnosis of gastric cancer, but it is not appropriate for screening gastric cancer because of its discomfort and high cost. The detection of serum tumor markers is simple in cancer screening and diagnosis, but it is difficult to be a conventional method for gastric cancer screening for its poor sensitivity and specificity (Sturgeon et al, 2010), only valuable in the prognostic evaluation of patients with gastric cancer (Dilege et al, 2010;Duraker et al, 2001;Emoto et al, 2012;Li et al, 2011;Ychou et al, 2000). Recently, a lot of studies were performed in serum proteomics and epigenetics and found some new markers with potential clinical significance in patients with gastric cancer.…”