Yuan Xiao-Wen, Feng Jia-Hao, Huang De Bing, Lu Zhan-Tao, Ye Hui-Ling, Chen Ping, Deng Lv
Department of Laboratory Medicine of The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, 528200, Guangdong, China.
Department of Laboratory Medicine of People's Hospital of Rongjiang County, Rongjiang, 557200, Guizhou, China.
World J Surg Oncol. 2025 Apr 12;23(1):142. doi: 10.1186/s12957-025-03789-z.
Serum tumour markers (TMs) such as alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199) and CA125 have been established as prognostic indicators for gastric cancer (GC); however, the diagnostic value of these markers for GC in older adults has yet to be examined. Therefore, this study aimed to explore the diagnostic and prognostic significance of AFP, CEA, CA199 and CA125 for GC in elderly individuals.
A total of 188 patients who visited The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, from May 2021 to March 2024 were selected for this study. TMs, namely, CA199, CA125, CEA, and AFP, were examined in all patients. Comparisons of these TMs were conducted among the three groups, and TM levels were compared in patients with GC at various TNM stages. The diagnostic value of these TMs for GC was evaluated by calculating the area under the curve (AUC).
We selected 89 patients diagnosed with GC: 52 patients with benign gastric diseases and 47 healthy individuals for our study. The positivity rates of AFP, CA125, CEA and CA199 were significantly greater in the GC group (31.46%, 31.46%, 43.82% and 23.60%, respectively) than in the benign gastric disease group and healthy control group. The diagnostic sensitivities of CEA, CA125, CA199 and AFP for GC were 31.46%, 29.21%, 44.90% and 24.72%, respectively. The combination of these markers yielded a sensitivity of 65.17%, which was significantly greater than the sensitivity of each marker alone (P < 0.05). Additionally, patients with stage I-II disease had significantly lower serum levels of CEA, CA199, CA125, and AFP than did those with stage III-IV disease.
The levels of serum TMs, including CA12-5, CEA, CA199 and AFP, are elevated in elderly individuals with GC, indicating a higher TNM stage. The combination of CEA, CA12-5, CA199 and AFP has enhanced diagnostic value for GC, thereby offering significant clinical guidance. However, this study is limited by its retrospective design and lack of external validation, which should be addressed in future prospective trials.
血清肿瘤标志物（TMs），如甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原199（CA199）和CA125，已被确立为胃癌（GC）的预后指标；然而，这些标志物对老年胃癌患者的诊断价值尚未得到研究。因此，本研究旨在探讨AFP、CEA、CA199和CA125对老年胃癌患者的诊断和预后意义。
本研究选取了2021年5月至2024年3月期间到华南理工大学医学院附属第六医院就诊的188例患者。对所有患者检测了TMs，即CA199、CA125、CEA和AFP。在三组之间对这些TMs进行了比较，并对不同TNM分期的胃癌患者的TM水平进行了比较。通过计算曲线下面积（AUC）评估这些TMs对胃癌的诊断价值。
我们选取了89例确诊为胃癌的患者：52例患有良性胃部疾病的患者和47例健康个体作为研究对象。AFP、CA125、CEA和CA199的阳性率在胃癌组（分别为31.46%、31.46%、43.82%和23.60%）显著高于良性胃部疾病组和健康对照组。CEA、CA1十二5、CA199和AFP对胃癌的诊断敏感性分别为31.46%、29.21%、44.90%和24.72%。这些标志物联合使用时的敏感性为65.17%，显著高于各标志物单独使用时的敏感性（P < 0.05）。此外，I-II期疾病患者的血清CEA、CA199、CA125和AFP水平显著低于III-IV期疾病患者。
包括CA12-5、CEA、CA199和AFP在内的血清TMs水平在老年胃癌患者中升高，表明TNM分期较高。CEA、CA12-5、CA199和AFP联合使用对胃癌具有更高的诊断价值，从而提供重要的临床指导。然而，本研究受其回顾性设计和缺乏外部验证的限制，这应在未来的前瞻性试验中加以解决。
