VALUE OF TUMOR-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 a nd the cardioembryonic antigen (CEA) in the follow-up of patients afte r potentially curative surgery of gastric carcinoma. Patients and meth ods: CA72-4, CA19-9 and CEA were measured prospectively in 279 patient s 1-36 months after potentially curative primary surgery for histologi cally proven gastric carcinoma. Evaluation was by ''receiver-operating -characteristics'' (ROC) curves using ''believe the positive'' rules a s well as by linear combinations. Results: Recurrences were found in 5 4 patients. CA72-4 (by radioimmunoassay) was the most sensitive single test (sensitivity 43 %, specificity 95 %). Radioimmunological and enz yme-immunological tests of CA 79-4 correlated well (r = 0.8). The vari ous values, obtained by certain test kits, when newly calculated for t he 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 pa tients after operation for gastric carcinoma. Single measurements of C A74-2 are as a rule preferable to those of CA19-9 or of both CA11-9 an d CEA. In fact, CEA should be measured only in exeptional circumstance s. But combined measurements of CA72-4 and CA19-9 increase sensitivity and prognostic value of the results.