A Comparison of Ten Serological Tumor Markers for the Detection of Gastric Cancer
Abstract
Gastric cancer comprises only 2% of cancer cases in the United States but represents the mostprevalent cancer in less developed countries and the fourth most prevalent cancer world wide. Earlydiagnosis and therapeutic intervention could radically reduce the number of deaths attributed to thisdisease. For this reason, minimally invasive cancer specific tests are urgently sought and recentlyhave included the serological tumor markers. The objective of this study was to compare ten tumorantigens (carcinoembryonic antigen [CEA], CA 19-9, CA 195, CA 50, CA 72-4, CA 125, CA 15-3,CA 27.29, alpha-fetoprotein [AFP], and Cyfra 21-1) for their diagnostic efficacy in gastric cancerpatients. The assays used in this study included CA 72-4, CA19-9, CA 15-3, CA 125, CA 27.29, andCyfra 21-1 from Fujirebio Diagnostics/Centocor Inc., CA 195 and CEA from Hybritech, Inc., CA50 from CIS bio international, and AFP from Abbott Inc. Sera from 200 healthy adults were usedto determine the normal reference intervals. Diagnostic parameters were determined using sera from554 patients including 184 with no disease, 11 with non-malignant disease, 12 with gastric cancer,and 347 with other types of cancer. The diagnostic sensitivities included: CA 50 ( 70%), CA 19-9(64%), CA 195 (58%), CEA (50%), CA15-3 (45%), CA 125 (40%), CA 27.29 (30%), CA 72-4(27%), AFP (22%), and Cyfra 21-1 (9%). With the exception of CA 195 and CA 15-3 (75%specificity), all the markers had diagnostic specificities equal to or greater than 80% (range80–95%). Analytical parameters were evaluated for the assays and compared favorably. Weconcluded that CA 50 was the best tumor antigen for use in the diagnosis of gastric cancer.Keywords: cancer, gastric cancer, stomach cancer, carcinoembryonic antigen, alpha-fetoprotein,CEA, AFP, CA 50, CA 19-9, CA 195, CA 72-4, CA 125, CA 15-3, CA 27.29, Cyfra 21-1, tumormarker.