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Tumor Markers for Diagnosis, Monitoring of Recurrence and Prognosis in Patients with Upper Gastrointestinal Tract Cancer

  • Jing, Jie-Xian (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Wang, Yan (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Xu, Xiao-Qin (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Sun, Ting (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Tian, Bao-Guo (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Du, Li-Li (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Zhao, Xian-Wen (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital) ;
  • Han, Cun-Zhi (Department of Etiology and Tumor Markers Laboratory, Shanxi Cancer Hospital)
  • 발행 : 2015.01.06

초록

To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of these tumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancer between January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA. The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%, 25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 had higher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCC was the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 and CA24-2, SCC and CA72-4 was significantly associated with pathological types (p<0.05) and TNM staging (p<0.05). Correlation analysis showed that CA24-2 was significantly correlated with CA19-9 (r=0.810, p<0.001). The levels of CEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasis and recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperative CA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combined detection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC; CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA and CA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumor recurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis of patients with upper GIT cancer.

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참고문헌

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