Clinical evaluation of CEA, CA19-9, CA72-4 and CA125 in gastric cancer patients with neoadjuvant chemotherapy

Abstract

BackgroundIn the clinical practice of neoadjuvant chemotherapy, response markers are very important. We aimed o investigate whether tumor markers CEA(carcino-embryonic antigen), CA19-9(carbohydrate antigen 19–9), CA72-4(carbohydrate antigen 72–4), and CA125(carbohydrate antigen 125) can be used to evaluate the response to neoadjuvant chemotherapy, and to evaluate the diagnosis and prognosis value of four tumor markers in the patients of gastric cancer.MethodsA retrospective review was performed of 184 gastric cancer patients who underwent a 5-Fu, leucovorin, and oxaliplatin (FOLFOX) neoadjuvant chemotherapy regimen, followed by surgical treatment. Blood samples for CEA, CA19-9, CA72-4, and CA125 levels were taken from patients upon admission to the hospital and after neoadjuvant chemotherapy. Statistical analysis was performed to identify the clinical value of these tumor markers in predicting the survival and the response to neoadjuvant chemotherapy.ResultsMedian overall survival times of pretreatment CA19-9-positive and CA72-4-positive patients (14.0 +/−2.8 months and 14.8 +/−4.0 months, respectively) were significantly less than negative patients (32.5 +/−8.9 months and 34.0 +/−10.1 months, respectively) (P = 0.000 and P = 0.002, respectively). Pretreatment status of CA19-9 and CA72-4 were independent prognostic factors in gastric cancer patients (P = 0.029 and P = 0.008, respectively). Pretreatment CEA >50 ng/ml had a positive prediction value for clinical disease progression after neoadjuvant chemotherapy according to the ROC curve (AUC: 0.694, 95% CI: 0.517 to 0.871, P = 0.017). The decrease of tumor markers CEA, CA72-4, and CA125 was significant after neoadjuvant chemotherapy (P = 0.030, P = 0.010, and P = 0.009, respectively), especially in patients with disease control (including complete, partial clinical response, and stable disease) (P = 0.012, P = 0.020, and P = 0.025, respectively). A decrease in CA72-4 by more than 70% had a positive prediction value for pathologic response to neoadjuvant chemotherapy according to the ROC curve (AUC: 0.764, 95% CI: 0.584 to 0.945, P = 0.020).ConclusionsOur results suggest that high preoperative serum levels of CA72-4 and CA19-9 are associated with higher risk of death, high pretreatment CEA levels (>50 ng/ml) may predict clinical disease progression after neoadjuvant chemotherapy, and a decrease (>70%) of CA72-4 may predict pathologic response to neoadjuvant chemotherapy.

WITHDRAWN: Diagnostic performance of carbohydrate antigen 72-4 for gastrointestinal malignancy screening in Chinese patients: a prospective study

“…Secondly, most previous CA72-4-related studies paid more attention to increasing the accuracy of GC diagnosis by combining with other tumor markers [13,14,15] and there was few study concentrating on the sole diagnostic value of CA72-4 in differentiating malignant diseases. As a result, the data of our research could help clinical doctors to determine whether it is necessary to detect CA72-4, thus saving healthcare costs and reduce anxiety.…”

“…Although there were many studies about CA72-4, most of them focused on improving the accuracy of diagnosis in malignances by combination of other tumor markers [13][14][15], none of which showed satisfying results. Besides, most previous studies concerned about the diagnostic role of CA72-4 in digestive malignances especially in GC [16].…”

Primary Small Bowel Adenocarcinoma the Rare Cause of Anemia – A Case Report

“…Both markers are reported to be related to stomach cancer. In a study on the association of 5 tumor markers with stomach cancer, CYFRA 21-1 was the most sensitive one, and CA 72-4 are significantly related to lymph node involvement, metastasis or stage [13,14]. Those markers elevations are often seen in non-specific scenario of malignancy, inflammation, or in smokers.…”

The clinical utility of CA125/MUC16 in pancreatic cancer: A consensus of diagnostic, prognostic and predictive updates by the Chinese Study Group for Pancreatic Cancer (CSPAC)

“…A previous study demonstrated an association between the dynamic changes in CA125 levels, tumor size reduction, the remission of clinical symptoms and chemotherapeutic effects (6). Additional studies have indicated that the elevation in the serum levels of CA125 correlate with cancer progression and treatment effects (72,73). Our team previously showed a better efficacy for CA125 compared with CA19-9 levels in determining the resectability of PC (38).…”