[Value of tumor-associated antigens CA 72-4 vs. CEA and CA 19-9 in the follow-up after stomach cancer].

OBJECTIVE

To compare the value of tumour markers CA-72-4 and CA 19-9 and the cardioembryonic antigen (CEA) in the follow-up of patients after potentially curative surgery of gastric carcinoma.

PATIENTS AND METHODS

CA 72-4, CA 19-9 and CEA were measured prospectively in 279 patients 1-36 months after potentially curative primary surgery for histologically proven gastric carcinoma. Evaluation was by "receiver-operating-characteristics" (ROC) curves using "believe the positive" rules as well as by linear combinations.

RESULTS

Recurrences were found in 54 patients. CA 72-4 (by radioimmunoassay) was the most sensitive single test (sensitivity 43%, specificity 95%). Radioimmunological and enzyme-immunological tests of CA 79-4 correlated well (r = 0.8). The various values, obtained by certain test kits, when newly calculated for the purpose of after-care, differed markedly from upper limits reported by the manufacturers. Measurement of both CA 72-4 and CA 19-9 increased the sensitivity to 54%.

INTERPRETATION

Special levels of CA 72-4 and CA 19-9 have been identified which are of value in the follow-up of patients after operation for gastric carcinoma. Single measurements of CA 74-2 are as a rule preferable to those of CA 19-9 or of both CA 11-9 and CEA. In fact, CEA should be measured only in exceptional circumstances. But combined measurements of CA 72-4 and CA 19-9 increase sensitivity and prognostic value of the results.