ANALYSIS OF THE APPLICATION VALUE OF CA199, CA724 AND CEA IN EARLY DIAGNOSIS AND PROGNOSIS OF GASTRIC CANCER

Mingli Zhang^*, Liqun Hua, Hao Ding 

 Department of Gastroenterology, the First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, China

Objective: To analyze the value of macromolecular carbohydrate antigen 199 (CA199), macromolecular carbohydrate antigen 72-4 (CA724) and carcinoembryonic antigen (CEA) in the early diagnosis and prognosis of gastric cancer.

Methods: A total of 154 patients with gastric cancer admitted to our hospital from January 2019 to January 2020 were included in the gastric cancer group, 63 patients with benign gastric disease were included in the benign gastric disease group, and 40 healthy people who had a physical examination in the physical examination center of our hospital during the same period were selected as the control group. According to pTNM staging, the patients were divided into group I-II (n=73), group III (n=51) and group IV (n=30). Patients were divided into the good prognosis group (n=85) and poor prognosis group (n=69) according to their prognoses. In the morning, 3mL of fasting venous blood was collected from all subjects, and serum CA199, CA724 and CEA levels were detected by electrochemical luminescence immunoassay. The serum CA199, CA724 and CEA levels for the groups were compared. ROC curves were used to analyze the value of CA199, CA724 and CEA in the early diagnosis and prognosis of gastric cancer.

Results: The serum levels of CA199, CA724 and CEA in the gastric cancer group and the benign gastric disease group were significantly higher than those in the control group, and the serum levels of CA199, CA724 and CEA in the gastric cancer group were significantly higher than those in the benign gastric disease group (P<0.05). The serum CA199, CA724 and CEA levels in groups IV and III were markedly higher than those in group I-II, and serum CA199, CA724 and CEA levels in group IV were significantly higher than those in the group III (P<0.05). The serum CA199, CA724 and CEA levels of gastric cancer patients in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05). ROC curve analyses showed that the area under the curve (AUC), sensitivity and specificity of CA199 for the early diagnosis of gastric cancer were 0.758, 78.64% and 75.21%, respectively. The AUC, sensitivity and specificity of CA724 in the early diagnosis of gastric cancer were 0.702, 72.64% and 68.34%, respectively, whereas the AUC, sensitivity and specificity of CEA in the early diagnosis of gastric cancer were 0.628, 65.39% and 67.94%, respectively. Finally, the AUC, sensitivity and specificity of the combination of these three indicators in the diagnosis of early gastric cancer were 0.878, 89.34% and 85.14%, respectively. The AUC, sensitivity and specificity of CA199 in gastric cancer prognosis were 0.736, 73.65% and 76.94%, respectively. The AUC, sensitivity and specificity of CA724 in gastric cancer prognosis were 0.715, 73.64% and 75.54%, respectively, whereas the AUC, sensitivity and specificity of CEA in gastric cancer prognosis were 0.658, 68.31% and 66.49%, respectively. Finally, the AUC, sensitivity and specificity of the combined indicators in gastric cancer prognosis were 0.859, 86.37% and 84.15%, respectively.  

Conclusion: The levels of serum CA199, CA724 and CEA in gastric cancer patients were significantly high and changed with the severity of the disease and the prognosis of the patients. Therefore, the serum levels of CA199, CA724 and CEA in gastric cancer patients are of certain value in the early diagnosis and prognosis of gastric cancer; however, the combination of the three indicators was of high value in diagnoses and could be widely used in clinical practice.