Gökhan ÇAKIRCA, CEMAL POLAT, ALİ İNAL, Mehmet KÜÇÜKÖNER, NURİYE METE, Fatma Birgül IŞIK

Mide kanserinde CYFRA 21-1, CEA, CA 19-9 ve CA 72-4 düzeylerinin karşılaştırılması

Amaç: Mide kanseri dördüncü en sık görülen kanser olup, dünyada kanser ölümlerinin ikinci en sık nedenidir. Bu çalışmada mide kanserinin tanı ve takibinde tümör markırları olan CYFRA 21-1, CA 19-9, CEA ve CA 72-4’ün rollerinin araştırılması amaçlandı. Yöntemler: Çalışmamıza mide kanseri tanısı almış 30 hasta ve 30 sağlıklı birey alındı. Mide kanserli hasta gru bunun TNM evrelendirme sistemine göre 16’sı Evre II, 14’ü Evre III idi. CEA, CA 19-9, CA 72-4 ve CYFRA 21-1 düzeyleri, elektrochemiluminescence immunasay (EC- LIA) metod ile Cobas e 601 cihazında çalışıldı. Bulgular: Mide kanserli hasta grubunun CA 72-4, CA 19- 9, CEA ve CYFRA 21-1 düzeyleri sağlıklı kontrol grubuna göre istatistiksel olarak anlamlı yüksek bulundu (p

Comparison of CYFRA 21-1, CEA, CA 19-9 and CA 72-4 levels in gastric cancer

Objective: Gastric cancer is the fourth most common ma lignancy, and the second most common cause of cancer mortality worldwide. The aim of this study was to investi gate the role of biomarkers CYFRA 21-1, CA 19-9, CEA, CA72.4 at diagnosis and throughout the follow-up in pa tients with gastric cancer. Methods: 30 patients with gastric cancer diagnosed and 31 healthy people as a control group were included in this study. According to the TNM staging system, there were 16 patients with stage II and 14 patients with stage III in the group of patients with gastric cancer. CEA, CA 19-9, CA 72-4 and CYFRA 21-1 levels were studied by elektro- chemiluminescence immunasay (ECLIA) method in the Cobas e 601 instrument. Results: Statistically the level of CA 72-4, CA 19-9, CEA and CYFRA 21-1 gastric cancer groups was found sig- nificant high accaording to healthy control group (p<0.01). Statistically compared with II stage patient group, the lev el of CA 19-9, CEA and CYFRA 21-1 of III stage patient group was found significant high (p<0.01). The diagnostic cut-off, sensitivity and specificity for CEA were 4.15 ng/ mL, 46 % and 96%, respectively; for CA 19-9 were 24.50 U/mL, 17 % and 96 %; for CA 72-4 were 2.46 U/mL, 53 % and 96% and for CYFRA 21-1 were 3.36 ng/mL, 46% and 100%. Conclusion: Our study demonstrates that the associa tion of biomarkers CYFRA 21-1, CEA, and CA72.4 pro vides a valuable contribution in the follow-up of gastric cancer patients.

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1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statis tics, 2002. CA Cancer J Clin 2005;55:74-108.
2. Bodenmueller H, Ofenloch-Hahnle B, Lane EB, Dessauer A. Lung Cancer associated Keratin 19 Fragments: Devel opment and Biochemical Characterization of the new Se rum Assay Enzymun- Test Cyfra 21-1. Int J Biol Markers 1994;9:75-81.
3. Bodenmueller H. The biochemistry of Cyfra 21-1 and other cytokeratin-tests. Scand J Clin Lab Suppl Invest 1995;221:60-66.
4. Stieber P, Dienemann H, et al. Comparison of Cytokera tin Fragment 19 (Cyfra 21-1) Tissue Polypeptide Antigen (TPA) and Tissue Polypeptide Specific Antigen (TPS) as Tumor Markers in Lung Cancer. Eur J Clin Chem Clin Bio chem 1993;31:689-694.
5. Bodenmueller H, Donie F, Kaufmann M, Banauch D. The tumor markers TPA, TPS TPACYK and Cyfra 21-1 react differently with the keratins 8, 18 and 19. Int J Biol Markers 1994;9:70-74.
6. Stieber P, Hasholzner U, et al. Cyfra 21-1: A new marker in lung cancer. Cancer 1993;72:707-713.
7. Grem J. The prognostic importance of tumor markers in ade nocarcinomas of the gastrointestinal tract. Curr Opin Oncol 1997;4:380-387.
8. Kirkwood KS, Khitin LM, Barwick KW. Prognostic indi cators for cancer. Gastric cancer. Surg Oncol Clin N Am 1997;6:495-514.
9. Micali B, Florio MG, Venuti A, et al. Usefulness of carcino embryonic antigen measurement in gastric juice of patients with gastric disorders. J Clin Gastroenterol 1983;5:411-415.
10. Piantino P, Taccone W, Fusaro A, et al. Significance of CA 72.4 serum levels in gastrointestinal diseases. Int J Biol Markers 1990;5:77-80.
11. Göral V, Yeşilbağdan H, et al. Mide kanserinde yeni bir tümör markeri olan CA 72-4’ün yeri. Turkiye Klinikleri J Med Sci 2006;26:3-8.
12. Stephen B. Edge,carolyn C. Compton, The American Joint Committee on Cancer: the 7 th edition of the AJCC cancer staging Manual and the future of TNM. Ann Surg Oncol 2010;17:1471-1474.
13. Joypaul B, Browning M, Newman E, et al. Comparison of serum CA 72-4 and CA 19-9 levels in gastric cancer patients and correlation with recurrence. Am J Surg 1995;169:595- 599.
14. Kodama I, Koufuji K, Kawabata S, et al. The clinical effi cacy of CA 72-4 as serum marker for gastric cancer in com parison with CA 19-9 and CEA. Int Surg 1995;80:45-48.
15. Nakata B, Chung YS, et al. Clinical significance of serum Cyfra 21-1 in gastric cancer. British Journal of Cancer 1996;73:1529-1532.
16. Byrne DJ, Browning MC, Cuschieri A. CA 72-4: A new tumor marker for gastric cancer. Br J Surg 1990;77:1010- 1013.
17. Stieber P, Bodenmuller H, Banauch D, et al. Cytokeratin
19 fragments: a new marker for non-small-cell lung cancer. Clin. Biochem 1993;26:301-304.
18. Marrelli D, Roviello F, De Stefano A, et al. Prognostic sig nificance of CEA, CA 19-9 and CA 72-4 preoperative serum levels in in gastric carcinoma. Oncology 1999;57:55-62.