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KMID : 0857020000150010020
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Kosin Medical Journal
2000 Volume.15 No. 1 p.20 ~ p.28
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Clinical Utility of Serum CA72-4 in the Diagnosis and Staging of Gastric Carinoma
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Song Soo-Keun
Kim Hyun-Joo
Son Ho-Sung
Jung Yeon-Soon
Chang Seong-Hoon
Chung Han-Ho
Kwon Ki-Byum
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Abstract
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Background/Objective: Various methods including upper GI series, endoscopy, ultrasound, CAT scan are used with serum tumor markers, especially CEA and CA19-9, for the diagnosis and evaluation of gastric carcinoma. In this study the clinical utility of serum CA72-4 of 300 gastric carcinoma patients for the diagnosis and management of gastric carcinoma was evaluated.
Methods : Serum level of CA72-4 was measured using Core CA72-4 RIA Kit(Packerd, USA). The cutoff level of serum CA72-4 was 4U/ml. The serum levels were correlated with t1e stage, the location of lesions, the gross type, the depth of invasion, the nodal and distant metastasis.
Results :1) Overall positivity of CA72-4 was 32.0%(96 cases). 2) There was no difference in the positivity of serum CA72-4 according to locations and gross types of the carcinoma, but significant(p<0.05) difference in the positivity of serum CA72-4 was noted between cases of early gastric carcinoma(12.3%) and advanced gastric carcinoma (37.4%). 3) The positivity, of serum CA72-4 of stage III and IV(49.5%) was significantly(p<0.05) higher than those of stage Ia(12.1%) and 11(16.0%). Furthermore, 87.5% of the cases of positive serum CA72-4 belonged to stage III or IV. 4) The positivity of serum CA72-4 were 12.3%, 14.3%, 34.7% and 52.6% for TI, T2, T3 and T4, respectively, showing relatively good correlation between CA72-4 positivity and depth of invasion. And 86.5% of the cases of positive serum CA72-4 belonged to T3 or T4 group. 5) The positivity of serum CA72-4 of N1 and N2 groups(35.1% and 41.7%, respectively) was significantly(p<0.05) higher than those of NO group(12.2%) and 89.6% of the cases of positive serum CA72-4 belonged to node positive cases. 6) In the cases of metastasis present, CA72-4 positivity was 47.4%, which was significantly(p<0.05) higher than that of metastasis-negative cases(28.4%). Among sites of metastasis, there was no difference in the positivity of CA72-4.
Conclusions :Serum CA72-4 was not useful as a screening test in the diagnosis of gastric carcinoma, but may be useful in differentiating between early and advanced cases, in determining stage of the disease, depth of invasion, serosal invasion, and especially in detecting nodal metastasis, and also useful when used with imaging modalities of diagnosis.
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KEYWORD
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Gastric carcinoma, CA72-4
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