An explorative study on the clinical utility of baseline and serial serum tumour marker measurements in advanced upper gastrointestinal cancer

Correlation of Serum CA242, CA724, and TPA Levels with Clinicopathological Features and Prognosis in Patients with Inflammatory Bowel Disease Complicated with Rectal Cancer

Objective. To investigate the correlation of serum cancer antigen 242 (CA242), cancer antigen 72-4 (CA724), and tissue polypeptide antigen (TPA) levels with clinicopathological features and prognosis in patients with inflammatory bowel disease (IBD) complicated with rectal cancer. Methods. The data of 120 patients with IBD were retrospectively analyzed. Patients were divided into the IBD group (without rectal cancer, $n=60$ ) and the rectal cancer group (with rectal cancer, $n=60$ ), and 60 healthy individuals receiving medical examination during the same period were selected as the healthy group. Serum CA242, CA724, and TPA levels of research subjects were measured by enzyme-linked immunosorbent assay (ELISA). Meanwhile, the clinical data of the patients were collected. The patients were followed up for 3 years and divided into the survival group and the dead group. The relationship between the levels of CA242, CA724, TPA, and prognosis was tested. Results. Significant differences were found in the serum CA242, CA724, and TPA levels among three groups ( $P<0.001$ ). CA242 was related to tumor size, histological stage, growth mode, and TNM stage in patients with IBD and rectal cancer. CA724 was related to histological stage, growth mode, depth of tumor invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), and TNM stage in patients with IBD and rectal cancer. TPA was related to histological stage, T stage, M stage, and TNM stage in patients with IBD and rectal cancer. Serum CA242, CA724, and TPA levels in the survival group were significantly lower than those in the dead group after 3 years ( $P<0.001$ ). As for the combined prediction of serum CA242, CA724, and TPA for patients’ prognosis, the confidence interval was 0.000-1.000, AUC was 0.875, standard error was 0.093, and sensitivity was 0.750. Conclusion. Serum CA242, CA724, and TPA levels are closely related to the clinicopathological features such as location, stage, and metastasis of rectal cancer. The combined detection of serum CA242, CA724, and TPA levels has a significant correlation with the prognosis of patients with rectal cancer, which can be used in monitoring the disease progression.

Associations between CA19-9 and CA125 levels and human epidermal growth factor receptor 2 overexpression in patients with gastric cancer

The aim of the present study was to investigate the association between serum carbohydrate antigen (CA)19-9 and CA125 levels, and human epidermal growth factor receptor 2 (HER2) expression in patients with gastric cancer, as well as to identify any correlation between them and the risk of recurrence and metastasis. A total of 256 patients were enrolled in the present study, and 219 patients were followed-up to investigate recurrence and metastasis of gastric cancer. Immunohistochemistry was used to detect HER-2 in gastric adenocarcinoma and paracancerous tissues. The positive rate of CA19-9 and CA125 in stages III/IV was higher compared with that in stages I/II. The positive rate of HER2 in distinct stages of gastric cancer was not statistically different. Serum CA19-9 and CA125 were not associated with the positive expression of HER2. The recurrence and metastasis of CA19-9, CA125 and HER2-positive gastric cancer were increased compared with those experienced by CA19-9, CA125 and HER2-negative patients. Age, stage and preoperative tumor markers were associated with 3-year prognosis of gastric cancer. HER2 [odds ratio (OR)=2.55] and CA19-9 (OR=1.22) were independent prognostic factors in patients with gastric cancer. CA19-9, CA125 and HER2 may be used to predict the recurrence or metastasis of gastric cancer. The combined detection may be able to improve the sensitivity and efficiency of predicting the recurrence or metastasis of gastric cancer. Preoperative positive serum for CA19-9 and CA125 were associated with poor prognosis in patients with gastric cancer. CA19-9 and HER2 were independent prognostic factors of gastric cancer.

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

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.