The importance of CA 72-4 and CA 19-9 dosing in gastric cancer

Clinical value of CA125, AFP, and CEA for combined diagnosis and assessment of gastric cancer prognosis

To analyze the diagnostic and prognostic value of combined detection of CA125, AFP, and CEA for gastric cancer. Ninety-eight gastric cancer patients treated in our hospital from January 2020 to November 2022 were retrospectively selected and classified into the gastric cancer group according to screening criteria, while 80 patients diagnosed with benign gastric lesions during the same period were classified into the benign group. Serum levels of CA125, AFP, CEA, and their positive rates were significantly higher in the gastric cancer group compared to the benign group (P<0.05). The AUCs for CA125, AFP, CEA, and their combined detection in diagnosing gastric cancer were 0.815, 0.813, 0.911, and 0.919, respectively (P<0.001). In patients with stage III-IV, the levels of CA125, AFP, and CEA were higher than those in stage I-II (P<0.05). The AUCs for serum CA125, AFP, CEA, and their combined detection in TNM staging of gastric cancer were 0.751, 0.834, 0.911, and 0.931, respectively (P<0.001). Poorly differentiated patients had higher levels of CA125, AFP, and CEA compared to moderately to well-differentiated patients (P<0.05). The AUCs for serum CA125, AFP, CEA, and their combined detection in diagnosing differentiation degree were 0.819, 0.883, 0.746, and 0.986, respectively (P<0.001). Patients with metastasis had higher levels of CA125, AFP, and CEA compared to those without metastasis (P<0.05). The AUCs for serum CA125, AFP, CEA, and their combined detection in diagnosing metastasis were 0.716, 0.825, 0.863, and 0.892, respectively (P<0.001). The levels of CA125, AFP, and CEA of patients in the death group were higher than those in the survival group (P<0.05). The AUCs for serum CA125, AFP, CEA, and their combined detection in predicting clinical outcomes of gastric cancer patients were 0.713, 0.809, 0.922, and 0.926, respectively (P<0.001). Cox regression analysis indicated that TNM staging, peritoneal metastasis, and elevated CEA levels were independent risk factors for poor prognosis (mortality) in patients with gastric cancer (P<0.05). Serum levels of CA125, AFP, and CEA in patients with gastric cancer were significantly elevated and were correlated with the degree of differentiation and TNM staging. Combined detection had diagnostic efficacy in assessing metastasis and clinical outcomes.

Integrating TNF-α with Established Tumor Markers to Enhance Prognostic Accuracy in Gastric Cancer: A Prospective Observational Study

Background/Objectives: Gastric cancer remains a leading cause of cancer mortality worldwide. Reliable biomarkers are crucial for early detection, prognostication, and therapy monitoring. While classical tumor markers such as carcinoembryonic antigen (CEA), cancer antigen (CA)19-9, CA72-4, and alpha-fetoprotein (AFP) are used in clinical practice, their accuracy can be limited. Tumor necrosis factor alpha (TNF-α) is an inflammatory cytokine implicated in tumor progression, yet its relationship with established gastric cancer tumor markers has not been fully clarified. This study aimed to determine whether elevated TNF-α correlates with key tumor markers and disease stage in gastric cancer. Methods: In this prospective observational study, we enrolled 80 gastric cancer patients and 20 non-neoplastic controls. Baseline clinical data, laboratory parameters, and tumor markers (CEA, CA19-9, CA72-4, AFP) were recorded. TNF-α concentrations were measured using enzyme-linked immunosorbent assays. Correlation analyses and multivariate regression were performed to assess the relationship of TNF-α with tumor markers, inflammatory indices, and disease stage. Results: TNF-α was significantly elevated in gastric cancer patients (median 4.5 pg/mL) compared to controls (2.9 pg/mL). TNF-α showed a robust correlation with CA19-9 (rho = 0.502) and CA72-4 (rho = 0.385), and a moderate correlation with CEA (rho = 0.279). TNF-α concentrations were highest in Stage IV disease and in the intestinal-type histology. In regression analysis, only CA19-9 and CA72-4 remained independent predictors of TNF-α after controlling for clinical confounders. Conclusions: TNF-α is strongly associated with CA19-9 and CA72-4 and rises with advancing stage, highlighting its potential as an adjunct marker for assessing gastric cancer burden. These findings provide a rationale for further research on TNF-α as both a prognostic biomarker and a possible therapeutic target in gastric cancer.

Liquid biopsy in gastric cancer: A snapshot of the current state of the art

Circulating tumor DNA (ctDNA) is nowadays considered a robust source to search for druggable tumoral genetic alterations, and in some specific settings liquid biopsy (LB) is already part of the diagnostics scenario and it has successfully implemented in the everyday practice. Three strengths make LB an extraordinary tool: i) to represent the complex molecular mosaicism that characterizes spatially heterogeneous malignancies; ii) to monitor in real-time the tumoral molecular landscape (i.e. to depict the longitudinal/temporal tumor evolution); iii) to ensure molecular profiling even in those cases in which tissue sampling is not feasible or not adequate. This review provides a snapshot of the current state of the art concerning ctDNA assay utility in gastric cancer (GC), testing its robustness as marker and seeking to understand the reasons for the delay in its application in clinical practice.

Novel combined tumor autoantibody detection in serological diagnosis of gastric cancer

OBJECTIVE

Gastric cancer (GC) is a highly prevalent malignancy, yet its early diagnosis rate is generally low. Therefore, we have established a serum-based combined detection method based on tumor autoantibodies aimed at improving the diagnostic rate of gastric cancer.

METHODS

Through clinical studies, we selected a series of proteins aberrantly expressed in gastric cancer patients, including RalA, Survivin, NY-ESO-1, p53, Cyclin B1, and Koc, and expressed and purified them using prokaryotic expression and nickel column chromatography.

RESULTS

The levels of autoantibodies in the serum of gastric cancer patients and healthy individuals were measured using enzyme-linked immunosorbent assay (ELISA), and the diagnostic value of the combined detection of tumor autoantibodies for gastric cancer was evaluated through receiver operating characteristic (ROC) curve analysis. The levels of autoantibodies against RalA, Survivin, NY-ESO-1, p53, and Cyclin B1 in the serum of gastric cancer patients were significantly higher than those in healthy individuals (P < 0.05), while the level of Koc showed no significant difference between the two groups (P > 0.05), suggesting that Koc may not be suitable for serological diagnosis of gastric cancer. ROC analysis of the combined levels of autoantibodies against RalA, Survivin, NY-ESO-1, p53, and Cyclin B1 for gastric cancer diagnosis achieved a sensitivity of 73.68% and specificity of 78.13%, with an AUC value of 0.8767.

CONCLUSION

The combined tumor autoantibody detection established in this study may have promising potential applications in early screening and diagnosis of gastric cancer.

Diagnostic, prognostic, and predictive biomarkers in gastric cancer: from conventional to novel biomarkers

Gastric cancer is a major health concern worldwide. The survival rate of Gastric cancer greatly depends on the stage at which it is diagnosed. Early diagnosis is critical for improving survival outcomes. To improve the chances of early diagnosis, regular screening tests, such as an upper endoscopy or barium swallow, are recommended for individuals at a higher risk due to factors like family history or a previous diagnosis of gastric conditions. Biomarkers can be detected and measured using non-invasive methods such as blood tests, urine tests, breath analysis, or imaging techniques. These non-invasive approaches offer many advantages, including convenience, safety, and cost-effectiveness, making them valuable tools for disease diagnosis, monitoring, and research. Biomarker-based tests have emerged as a useful tool for identifying gastric cancer early, monitoring treatment response, assessing the recurrence risk, and personalizing treatment plans. In this current review, we have explored both classical and novel biomarkers for gastric cancer. We have centralized their potential clinical application and discussed the challenges in Gastric cancer research.

Detection of chromosomal instability using ultrasensitive chromosomal aneuploidy detection in the diagnosis of precancerous lesions of gastric cancer

Background

The diagnosis of Precancerous Lesions of Gastric Cancer (PLGC) is challenging in clinical practice. We conducted a clinical study by analyzing the information of relevant chromosome copy number variations (CNV) in the TCGA database followed by the UCAD technique to evaluate the value of Chromosomal Instability (CIN) assay in the diagnosis of PLGC.

Methods

Based on the screening of gastric cancer related data in TCGA database, CNV analysis was performed to explore the information of chromosome CNV related to gastric cancer. Based on the gastroscopic pathology results, 12 specimens of patients with severe atrophy were screened to analyze the paraffin specimens of gastric mucosa by UCAD technology, and to explore the influence of related factors on them.

Results

The results of CNV in TCGA database suggested that chromosome 7, 8, and 17 amplification was obvious in patients with gastric cancer. UCAD results confirmed that in 12 patients with pathologic diagnosis of severe atrophy, five of them had positive results of CIN, with a positive detection rate of 41.7%, which was mainly manifested in chromosome seven and chromosome eight segments amplification. We also found that intestinalization and HP infection were less associated with CIN. And the sensitivity of CIN measurement results was significantly better than that of tumor indicators.

Conclusion

The findings suggest that the diagnosis of PLGC can be aided by UCAD detection of CIN, of which Chr7 and 8 may be closely related to PLGC.

Determination of serum CA724 levels using fluorescence immunochromatography

BACKGROUND

Carbohydrate antigen 724 (CA724) is a sensitive and specific indicator for multiple malignant tumors. The aim of this study was to establish a Eu-time resolved fluorescence immunochromatography (Eu-TRFICO) method for quantitative detection of CA724 in serum.

METHODS

Eu-TRFICO strips were optimized and assembled. The sensitivity, specificity and precision were evaluated using CA724 standard dilutions and matrix serum. Meanwhile, the reference interval, comparison, and sensitivity/specificity were performed using clinical negative/positive gastric cancer serum samples.

RESULTS

The standard curve equation was y = 9.869 x - 154.12 (R2 = 0.993), and the sensitivity was 0.42 U/mL. The common interferents in serum could not affect the quantitative results with low cross-reactivities (all no more than 1.09%). All average recoveries of the intra- and interbatch ranged from 102.38 to 106.40%, and all CVs were below 10%. The reference interval of the healthy subjects was < 4.68 U/mL and the reference interval of the subjects with grade I/II gastric cancer was > 9.54 U/mL. Additionally, a high Pearson r (0.9503) and sensitivity/specificity (92.86%/94.20%) were obtained.

CONCLUSION

This study prepared Eu-TRFICO strips with high sensitivity, specificity, precision and satisfactory clinical testing performance, which provides more options for clinical quantitative and convenient testing of CA724.