CEA, CA19-9, and CA72-4 in Gastric Cancer Diagnosis and Progression: a Chinese Retrospective Case-Control Study

The usefulness of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA72-4 for diagnosis, predicting progression, and monitoring recurrence of gastric cancer (GC) remains unclear. We conducted a retrospective investigation in this study. A total of 564 GC cases were enrolled, and 529 cases with benign gastric disease were recruited as controls. The clinical data and results of biomarker detections were collected. The median concentrations (IQR) of CEA, CA19-9, and CA72-4 in GC patients were 2.38 ng/mL (1.47 - 4.47), 10.52 U/mL (6.17 - 20.20), and 2.42 U/mL (1.26 - 6.58), respectively, which were significantly different from those in controls (all p < 0.001). However, the areas under the ROC curve (AUCs) were 0.633, 0.565, and 0.621, respectively. When combining the three biomarkers, the optimal sensitivity, specificity, and AUC were 39.15%, 86.93%, and 0.652, respectively. The concentrations of biomarkers increased incrementally with the pathological stages (all p < 0.001). However, the PPVs in comparison with early/advanced GC, no/with lymph node metastasis, and distant metastasis were modest. No significant difference in preoperative levels was observed in patients with and without recurrence. Significant difference was shown in both recurrence and no recurrence group when com-paring the baseline and endpoint levels (all p < 0.05). CEA, CA19-9, and CA72-4 were not applicable biomarkers for diagnosis, and the combination did not achieve better diagnosis efficiency. The levels of biomarkers cannot predict advanced GC, lymph node metastasis, and distant metastasis well. The measurements of biomarkers may not effectively identify recurrence after curative radical gastrectomy.