Study on Value of Carbohydrate Antigen 72-4 in Tumor Screening and Diagnosis
10.3969/j.issn.1008-7125.2020.09.002
- Author:
Guozhen LIU
1
;
Jiayue TANG
1
;
Kaiming WU
1
;
Yong LIN
1
;
Guozhen LIU
2
;
Xin ZENG
3
;
Lin ZHOU
4
Author Information
1. Department of Gastroenterology, Changzheng Hospital, Naval Medical University
2. Department of Gastroenterology, Wusong Central Hospital
3. Department of Gastroenterology, Shanghai East Hospital, Tongji University
4. Department of Laboratory Diagnosis, Changzheng Hospital, Naval Medical University
- Publication Type:Journal Article
- Keywords:
CA-72-4 Antigen;
Digestive System Neoplasms;
Follow-Up Studies;
Tumor Markers, Biological;
Tumor Screening
- From:
Chinese Journal of Gastroenterology
2020;25(9):521-526
- CountryChina
- Language:Chinese
-
Abstract:
Background: Carbohydrate antigen 72-4 (CA72-4) is generally recognized as a tumor marker of digestive system. However, elevated serum CA72-4 level is also evident in many benign diseases and healthy subjects, and its sensitivity in diagnosing malignant tumor is quite poor. Aims: To reassess the value of CA72-4 in tumor screening and diagnosis. Methods: Three cohorts were established in this study. Inpatients who underwent a serum CA72-4 measurement and had a definite final diagnosis were included into Cohort 1 (retrospective study). Inpatients with elevated serum CA72-4 level who had not been diagnosed as malignant tumor before admission were included into Cohort 2 (retrospective study). Individuals who underwent a serum CA72-4 measurement and willing to take a follow-up for at least 2 years were included into Cohort 3 (prospective study). Malignancies had been preliminarily excluded in all individuals in Cohort 3 before enrollment. Results: Among the 2 173 patients recruited in Cohort 1, the prevalence of positive serum CA72-4 was significantly higher in patients with malignancies than those without (16.4% vs. 7.4%, P<0.05). The sensitivity and specificity of CA72-4 for diagnosis of malignant tumor were 36.5% and 76.2%, respectively, at the cut-off value (2.955 U/mL) identified by ROC curve analysis. Among the 1 807 patients recruited in Cohort 2, most of the participants (76.5%) did not have malignancies. Serum CA72-4 level was associated with the histological classification, tumor differentiation and TNM staging of malignancies (P<0.05). Among the 376 individuals who underwent a follow-up for no less than 2 years in Cohort 3, elevated serum CA72-4 level did not increase the risk of malignant tumor (OR=1.268, 95% CI: 0.283-5.687). Conclusions: CA72-4 is not a sensitive marker for tumor screening, its value as an item in physical examination should be re-evaluated. In patients who had positive serum CA72-4 and malignant tumor was ruled out in initial examination, the necessity of long-term follow-up of serum CA72-4 needs to be discussed.
