CA 72 - 4 may contribute to real - time reconnaissance of gastric cancer

Data from prospective studies indicate a positive impact of gastric Objective: cancer screening programs on mortality associated with the disease. Unfortunately, endoscopic procedures, widely regarded as uncomfortable, face low patient compliance, thus underscoring the need for reliable biological markers capable of detection of tumor growth in bodily fluids. Furthermore, in light of the emerging patient-friendly, still devoid of histopathological capabilities, capsule endoscopy, gastric fluid may prove valuable for biomarker-assisted cancer diagnosis. We set out to determine whether CA72-4 measurement in gastric fluid may be of benefit for detection of gastric cancer. : Open prospective study. Design Sample collection was performed at a tertiary referral center for Setting: patients with gastroenterological diseases; immunological analysis was performed at the R&D facility of a commercial biotechnology company. Studies were part of an EU-FP6 project (NEMO). 176 patients referred for endoscopy due to gastrointestinal Patients: complaints. Gastric juice was aspirated endoscopically according to Interventions: standard operating procedures, volume and pH were measured immediately and samples stored at -80°C. Concentration of CA72-4 tumor marker was evaluated Outcome measures: by enzyme-linked immunosorbent assay (ELISA). Median CA72-4 levels were about 4-fold higher in cancer patients Results: compared with patients with normal gastric findings, gastric inflammation, intestinal metaplasia or other diseases (p=0.001). Multivariate linear regression analysis revealed that elevated CA72-4 was significantly predicted by gastric carcinoma adjusted for H. pylori status, age, smoking status, PPI dose, and pH of aspirate (R2=0.27, p<0.0001). In this model, diagnosis of gastric carcinoma had by far the greatest influence. At a cut-off level of 100 U/ml, CA72-4 had 75% sensitivity and 89% specificity for detection of gastric cancer. Based on our findings, CA72-4 level assessment in gastric fluid, Conclusions: featuring yet unmatched accuracy of malignant neoplasia detection may prove beneficial for gastric cancer screening. 1 2 2 1 2