Five common tumor biomarkers and CEA for diagnosing early gastric cancer

Abstract

Background:Although surgical resection is the recommended treatment for the patients with gastric cancer, lots of patients show advanced or metastatic gastric cancer at the time of diagnosis. Detection of gastric cancer at early stages is a huge challenge because of lack of appropriate detection tests. Unfortunately, existing clinical guidelines focusing on early diagnosis of gastric cancer do not provide consistent and prudent evidence. Serum carcinoembryonic antigen was considered as a complementary test, although it is not good enough to diagnose early gastric cancer. There are no other tumor markers recommended for diagnosing early gastric cancer. This study aims to evaluate and compare the diagnostic accuracy of 5 common tumor biomarkers (CA19–9, CA125, PG, IncRNA, and DNA methylation) and CEA and their combinations for diagnosing gastric cancer through network meta-analysis method, and to rank these tests using a superiority index.Methods:PubMed, EMBASE.com, and the Cochrane Central Register of Controlled Trials (CENTRAL) will be searched from their inception to March 2018. We will include diagnostic tests which assessed the accuracy of the above-mentioned tumor biomarkers and CEA for diagnosing gastric cancer. The risk of bias for each study will be independently assessed as low, moderate, or high using criteria adapted from Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Network meta-analysis will be performed using STATA 12.0 and R 3.4.1 software. The competing diagnostic tests will be ranked by a superiority index.Results:This study is ongoing and will be submitted to a peer-reviewed journal for publication.Conclusion:This study will provide systematically suggestions to select different tumor biomarkers for detecting the early gastric cancer.

Gastric Cancer: Epidemiology, Risk Factors, Classification, Genomic Characteristics and Treatment Strategies

“…Usually, single tumor markers are not sufficiently sensitive and specific, therefore, the combined detection of several markers is inherent. In cases of GC, serum CA 19-9, carcinoembryonic antigen (CEA), carbohydrate antigen 72-4 (CA 72-4) and carbohydrate antigen 15-3 (CA 15-3) are important during an early GC diagnosis and therapy monitoring [95,96].…”

Emergency exploratory laparotomy and radical gastrectomy in patients with gastric cancer combined with acute upper gastrointestinal bleeding

“…Similarly, CEA is a polysaccharide-rich protein complex and a carcinoembryonic antigen produced during embryonic and fetal stages. It has prognostic significance for GC and is associated with progressive poorly differentiated adenocarcinoma, tumor size, serosal surface invasion, and lymph node metastasis[ 38 ]. Furthermore, CA125, a glycoprotein tumor-associated antigen, has great clinical value in the diagnosis of ovarian cancer and shows positive reactions in other malignant tumors, such as GC, cervical cancer, and breast cancer[ 39 ].…”

Novel Drug Delivery Systems as an Emerging Platform for Stomach Cancer Therapy

“…Usually, single tumor markers are not satisfactorily specific and sensitive so several markers are used in combination. In stomach cancer, CA19-9, CEA, carbohydrate antigen 15-3 (CA 15-3), and carbohydrate antigen 72-4 (CA 72-4) in serum have a significance in the early diagnosis and therapeutic monitoring of stomach cancer [37][38][39].…”