Korean J Helicobacter Up Gastrointest Res.
2022 Mar;22(1):38-49. 10.7704/kjhugr.2021.0058.
Diagnostic Value of Ascitic Tumor Markers for Gastric Cancer-associated Malignant Ascites
- Yang Y
1 - Kim HJ2
- Go Si2
- Bae WK3,4
- Song EK5,6
- Byeon S1
- Kim HK1
- Jeong Y1
- Kwon J1,7
- Lee KH1,7
- Chae HB1,7
- Son SM8,9
- Kim DH10
- Yun HY10,11
- Han HS1,7
- Affiliations
-
- 1Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
- 2Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
- 3Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
- 4Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
- 5Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
- 6Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University, Jeonju, Korea
- 7Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
- 8Department of Pathology, Chungbuk National University Hospital, Cheongju, Korea
- 9Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
- 10Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
- 11Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
- KMID: 2527281
- DOI: http://doi.org/10.7704/kjhugr.2021.0058
Abstract
- Background/Aims
Peritoneal carcinomatosis with malignant ascites is common in patients with advanced gastric cancer (GC). The detection of tumor cells is the gold standard for the diagnosis of malignant ascites; however, it often requires complementary tests because of its low sensitivity. Herein, we measured the levels of tumor markers in the malignant ascites of GC patients (GC-ascites) and benign ascites of liver cirrhosis patients (LC-ascites) to elucidate the diagnostic value of tumor markers in GC-ascites.
Materials and Methods
The levels of CEA, cancer antigen 72-4 (CA 72-4), CA 19-9, and CA 125 were measured in 138 GC-ascites and 64 LC-ascites samples obtained from the National Biobank of Korea. We performed receiver operating characteristic curve analysis to determine the optimal cutoff value for each tumor marker.
Results
CEA, CA 72-4, and CA 19-9 levels were significantly higher in GC-ascites than in LC-ascites. There was no difference in tumor marker levels between GC-ascites samples irrespective of cytology. CEA, CA 72-4, and CA 19-9 had sensitivities of 85.5%, 79.0%, and 61.6%, respectively, and specificities of 96.8%, 100.0%, and 89.1%, respectively, for distinguishing GC-ascites samples from LC-ascites samples. The diagnostic accuracy was improved by combining two or more tumor markers. The combination of CEA and CA 72-4 showed the highest sensitivity (86.2%) and specificity (100%).
Conclusions
Measurement of tumor markers, such as CEA, CA 72-4, and CA 19-9, in ascites samples could help diagnose GC-ascites, and combining two or more tumor markers could further increase the diagnostic yield, even in cytology-negative patients.
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