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Gastric cancer

Gastric cancer was the fourth common cancer worldwide, and it was the second most common cause of death from cancer [1]. Gastric cancer can generally be classified into two topographical subsites, the cardia (upper stomach) and noncardia (lower stomach). Chronic Helicobacter pylori infection is considered the principal cause of noncardia gastric cancer, with almost all cases attributed to this bacterium. Meanwhile, cardia gastric cancer is considered to be linked to H. pylori infection, excess body weight and gastroesophageal reflux disease injury [2].Early detection is important for improving the survival rate of patients with gastric cancer (GC).

Some serum tumor markers including CEA, CA19-9, CA50, and CA72-4 have been reported to be elevated in some patients with gastric cancer [3–5].

Clinical Significance

CEA, CA19-9, CA-50

In advanced or recurrent gastric cancer, the estimation of either CA 19-9 or CA-50 and CEA serum values may help in checking the prognosis, determining the efficacy of palliative treatment modalities, and recognizing recurrences. [6]


CA72-4 is highly sensitive to gastric cancer, and the positive rate of serum CA72-4 in gastric cancer is reported to be 36% to 94%. And its specificity is also high, some of which even reach 100%.[7]CA72-4 can be used to detect whether there are residual tumor cells after operation and judge the prognosis of gastric cancer.[8]


[1].Suenaga Y, Kanda M, Ito S, Mochizuki Y, Teramoto H, Ishigure K, Murai T, Asada T, Ishiyama A, Matsushita H, Tanaka C, Kobayashi D, Fujiwara M, Murotani K, Kodera Y. Prognostic significance of perioperative tumor marker levels in stage II/III gastric cancer. World J Gastrointest Oncol 2019; 11(1): 17-27 [PMID: 30984347 DOI: 10.4251/wjgo.v11.i1.17]

[2] Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4. PMID: 33538338.

[3]Ychou M, Duffour J, Kramar A, Gourgou S, Grenier J: Clinical significance and prognostic value of CA 72-4 compared with CEA and CA19-9 in patients with gastric cancer. Dis Markers. 2000, 16: 105-110.

[4]Gao ZL, Zhang C, Du GY, Lu ZJ: Clinical significance of changes in tumor markers, extracellular matrix, MMP-9 and VEGF in patients with gastric carcinoma. Hepatogastroenterology. 2007, 54: 1591-1595.

[5]Adachi Y, Tsuchihashi J, Shiraishi N, Yasuda K, Etoh T, Kitano S: AFP-producing gastric carcinoma: multivariate analysis of prognostic factors in 270 patients. Oncology. 2003, 65: 95-101. 10.1159/000072332.

[6]D Pectasides 1, A Mylonakis, M Kostopoulou, M Papadopoulou, D Triantafillis, J Varthalitis, M Dimitriades, A Athanassiou. CEA, CA 19-9, and CA-50 in monitoring gastric carcinoma. Am J Clin Oncol. 1997 Aug;20(4):348-53. doi: 10.1097/00000421-199708000-00005.

[7]. Cappellani A, Zanghi A, Di Vita M, et al. Clinical and biological markers in gastric cancer: update and perspectives. Front Biosci (Schol Ed) 2010;2:403–12.

[8]. Nicolini A, Ferrari P, Duffy MJ, et al. Intensive risk-adjusted follow-up with the CEA, TPA, CA19.9, and CA72.4 tumor marker panel and abdominal ultrasonography to diagnose operable colorectal cancer recurrences: effect on survival. Arch Surg (Chicago, Ill: 1960) 2010;145:1177–83.

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