Release date: 2015-09-24
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Gastric cancer is one of the most common malignant tumors of the digestive system
The male incidence rate is 10/220,000 and the female is 10.4/100,000. In male tumors, gastric cancer is in third place and mortality is second. Among female tumors, gastric cancer is in fifth place and mortality is fourth.
What are the common tumor markers for gastric cancer?
Serological tumor markers commonly used in clinical practice include CEA, CA19-9, CA72-4, etc., but the sensitivity to early gastric cancer detection is less than 35%, which cannot be used for screening and early diagnosis of gastric cancer. In recent years, studies have suggested that pepsinogen (PG) can be used as a good indicator for early diagnosis of gastric cancer.
Carcinoembryonic antigen (CEA)
In 1965, Gold et al first discovered carcinoembryonic antigen (CEA) from colon tissue. Normal CEA secreted into the gastrointestinal tract and cancer cells that lost polarity secreted CEA into the blood and lymph. CEA is elevated in a variety of cancer patients, especially gastrointestinal tumors, with higher sensitivity. According to reports, the positive rate of CEA in the serum of various stages of gastric cancer is 8%~62.5%. The positive rate has a great relationship with the prognosis of tumor stage. It is closely related to the depth of tumor invasion and may indicate distant metastasis. Kim et al. used radioimmunoassay to detect CEA in patients with gastric cancer. It was found that preoperative CEA>10.0 mg/L had more serosal invasion and lymph node involvement than CEA<5.0 mg/L, and the degree of malignancy was high and the differentiation was poor. The postoperative survival is short. In postoperative patients, CEA can monitor whether the tumor has recurred. Patients with a rise in CEA after gastric cancer surgery often have recurrence and have a poor prognosis. CEA can also be used in combination with other indicators to evaluate the chemotherapy effect of gastric cancer. For example, CEA levels can be reduced to more than 50% or fall to the normal range for more than 4 weeks.
CA19-9
CA19-9 is a tumor marker associated with pancreatic cancer, gallbladder cancer, colon cancer and gastric cancer, also known as gastrointestinal cancer-associated antigen, which is similar to the antigenic determinant of CEA. In 1979, Koprowski used the monosialic ganglion glycoside isolated from the surface of human colon cancer cell line SW1116 as the antigen to prepare the corresponding monoclonal antibody 1116-NS-19-9, and the tumor-associated antigen recognized by the monoclonal antibody. It is called CA19-9. This antigen is also present in the pancreas, gallbladder, liver, intestines and other tissues of the fetus during embryogenesis, but the content in normal human tissues is very low, and the serum CA19-9 concentration in healthy adults is <37 U/L.
CA72-4
CA72-4 was first discovered by Gero equal to 1989. It contains two antibodies. B72.3 is a monoclonal antibody against breast cancer cell line. The antigen of CC49 is from rectal cancer. Healthy adult serum CA72-4 concentration <6U / L, the increase can be seen in 40% of gastrointestinal cancer, the positive rate of benign disease is about 5%. The sensitivity of CA72-4 is not high, but combined with CEA can improve the sensitivity and specificity of gastric cancer diagnosis. In addition, CA72-4 is considered to be a good indicator of disease stage and whether there is residual tumor in patients with gastrointestinal cancer, if cancer The tumor was completely removed and CA72-4 was reduced to normal.
Pepsinogen (PG)
Pepsinogen is a pepsin precursor secreted by gastric mucosa. It belongs to the aspartic protease family and is mainly synthesized by gastric main cells and cervical mucus cells. It can be divided into two subgroups: PGI secreted by the main cells of the fundus gland. And PGII secreted by the fundic glands, cardiac glands, pyloric glands, and Burnner glands. The ratio of PGI to PGI/PGII can reflect the functional status of gastric mucosa and is significantly correlated with the extent and severity of gastric mucosal atrophy. When gastric mucosa occurs, the content of pepsinogen in serum also changes. The PGI content and PG/PGII ratio of gastric cancer patients were significantly reduced, which can be used as an auxiliary index for the diagnosis of gastric cancer. Studies have shown that the sensitivity of PG for gastric cancer screening is 77% and the specificity is 73%.
Source: Medical Cancer Channel
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