Value of tumour-associated antigen CA 72-4 compared with CEA and CA 19-9 in the follow-up of patients operated for gastric carcinoma

Objective: To compare the value of tumour markers CA-72-4 and CA19-9 and the cardioembryonic antigen (CEA) in the follow-up of patients after potentially curative surgery of gastric carcinoma. Patients and methods: CA72-4, CA19-9 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. CA72-4 (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 CA72-4 and CA19-9 increased the sensitivity to 54 %. Interpretation: Special levels of CA72-4 and CA19-9 have been identified which are of value in the follow-up of patients after operation for gastric carcinoma. Single measurements of CA74-2 are as a rule preferable to those of CA19-9 or of both CA11-9 and CEA. In fact, CEA should be measured only in exeptional circumstances. But combined measurements of CA72-4 and CA19-9 increase sensitivity and prognostic value of the results.