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

World Journal of Surgical Oncology

Research

Nengwei Zhang¹  Zhipeng Sun² 

[1] Beijing Shijitan Hospital, Capital Medical University, Room 334, Administrative Building, 100038, Beijing, China;Oncology Surgery Department, Capital Medical Cancer Centre, Beijing Shijitan Hospital, Capital Medical University, 100038, Beijing, China;

关键词: Gastric cancer;    Neoadjuvant chemotherapy;    CEA;    CA19-9;    CA72-4;    CA125;   

DOI  :  10.1186/1477-7819-12-397

 received in 2014-10-05, accepted in 2014-12-05,  发布年份 2014

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© Sun and Zhang; licensee BioMed Central. 2015