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Comparative study of CEA and CA19-9 in esophageal, gastric and colon cancers individually and in combination (ROC curve analysis).

Bagaria B, Sood S, Sharma R, Lalwani S - Cancer Biol Med (2013)

Bottom Line: The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%.In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 (SE =0.05), with a significance level of P<0.0011.Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry, S.M.S. Medical College & Hospital, Jaipur 302004, India;

ABSTRACT

Objective: To determine the clinical serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers.

Methods: The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic (ROC) curves were plotted.

Results: Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined: in esophageal cancer, sensitivity=28%, negative predictive value (NPV)=61.72%, and AUC=0.742 
(SE=0.05), with a significance level of P<0.0001; in gastric cancer, sensitivity=30%, NPV=58.82%, and AUC=0.734 (SE=0.05), with a significance level of P<0.0001; in colon cancer, sensitivity=74%, NPV=79.36%, and AUC=0.856 
(SE=0.04), with a significance level of P<0.0001. The sensitivity of CA19-9 was also evaluated: in esophageal cancer, sensitivity=18%, NPV=54.94%, and AUC=0.573 (SE =0.05), with a significance level of P=0.2054. In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 (SE =0.05), with a significance level of P<0.0011. In colon cancer, sensitivity=26%, NPV=57.47%, and AUC=0.580 (SE =0.05), with a significance level of P=0.1670. The following were the sensitivities of CEA/CA19-9 combined: in esophageal cancer, sensitivity=42%, NPV=63.29%, SE=0.078 (95% CI: 0.0159-0.322); gastric cancer, sensitivity=58%, NPV=70.42%, SE=0.072 (95% CI: -0.0866-0.198); and colon cancer, sensitivity=72%, NPV=78.12%, SE=0.070 (95% CI: 0.137-0.415).

Conclusion: CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.

No MeSH data available.


Related in: MedlinePlus

CEA+CA19-9 ROC in esophagus cancer.
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f1: CEA+CA19-9 ROC in esophagus cancer.

Mentions: The sensitivity of CEA, CA19-9, and CEA/CA19-9, as well as the NPV for esophageal, gastric, and colon cancers were given in (Table 3, Figures 1,2,3). Serum CEA values exceed the threshold value in 38% of patients with esophageal cancer. NPV is 61.72%, AUC is 0.742 (SE=0.05), and the significance level is P<0.0001. CEA values exceed the threshold value in 30% of patients with gastric cancer. NPV is 58.82%, AUC is 0.734 (SE=0.05), and the significance level is P<0.0001. CEA values were higher than the threshold value in 74% of patients with colon cancer. NPV is 79.36%, AUC is 0.856 (SE=0.04), and the significance level is P<0.0001. The ideal threshold value identified from the ROC curve for CEA was >3.34 with a sensitivity of 50% (95% CI: 35.5-64.5) and a specificity of 100% in patients with esophageal cancer. The ideal threshold value based on the ROC curve for CEA was >3.34 with a sensitivity of 44% (95% CI: 30.0-58.7) and a specificity of 100% in patients with gastric cancer. The ideal threshold value based on the ROC curve for CEA was >3.34 with a sensitivity of 76% (95% CI: 61.8-86.9) and a specificity of 100% in patients with colon cancer.


Comparative study of CEA and CA19-9 in esophageal, gastric and colon cancers individually and in combination (ROC curve analysis).

Bagaria B, Sood S, Sharma R, Lalwani S - Cancer Biol Med (2013)

CEA+CA19-9 ROC in esophagus cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860340&req=5

f1: CEA+CA19-9 ROC in esophagus cancer.
Mentions: The sensitivity of CEA, CA19-9, and CEA/CA19-9, as well as the NPV for esophageal, gastric, and colon cancers were given in (Table 3, Figures 1,2,3). Serum CEA values exceed the threshold value in 38% of patients with esophageal cancer. NPV is 61.72%, AUC is 0.742 (SE=0.05), and the significance level is P<0.0001. CEA values exceed the threshold value in 30% of patients with gastric cancer. NPV is 58.82%, AUC is 0.734 (SE=0.05), and the significance level is P<0.0001. CEA values were higher than the threshold value in 74% of patients with colon cancer. NPV is 79.36%, AUC is 0.856 (SE=0.04), and the significance level is P<0.0001. The ideal threshold value identified from the ROC curve for CEA was >3.34 with a sensitivity of 50% (95% CI: 35.5-64.5) and a specificity of 100% in patients with esophageal cancer. The ideal threshold value based on the ROC curve for CEA was >3.34 with a sensitivity of 44% (95% CI: 30.0-58.7) and a specificity of 100% in patients with gastric cancer. The ideal threshold value based on the ROC curve for CEA was >3.34 with a sensitivity of 76% (95% CI: 61.8-86.9) and a specificity of 100% in patients with colon cancer.

Bottom Line: The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%.In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 (SE =0.05), with a significance level of P<0.0011.Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry, S.M.S. Medical College & Hospital, Jaipur 302004, India;

ABSTRACT

Objective: To determine the clinical serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers.

Methods: The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic (ROC) curves were plotted.

Results: Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined: in esophageal cancer, sensitivity=28%, negative predictive value (NPV)=61.72%, and AUC=0.742 
(SE=0.05), with a significance level of P<0.0001; in gastric cancer, sensitivity=30%, NPV=58.82%, and AUC=0.734 (SE=0.05), with a significance level of P<0.0001; in colon cancer, sensitivity=74%, NPV=79.36%, and AUC=0.856 
(SE=0.04), with a significance level of P<0.0001. The sensitivity of CA19-9 was also evaluated: in esophageal cancer, sensitivity=18%, NPV=54.94%, and AUC=0.573 (SE =0.05), with a significance level of P=0.2054. In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 (SE =0.05), with a significance level of P<0.0011. In colon cancer, sensitivity=26%, NPV=57.47%, and AUC=0.580 (SE =0.05), with a significance level of P=0.1670. The following were the sensitivities of CEA/CA19-9 combined: in esophageal cancer, sensitivity=42%, NPV=63.29%, SE=0.078 (95% CI: 0.0159-0.322); gastric cancer, sensitivity=58%, NPV=70.42%, SE=0.072 (95% CI: -0.0866-0.198); and colon cancer, sensitivity=72%, NPV=78.12%, SE=0.070 (95% CI: 0.137-0.415).

Conclusion: CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.

No MeSH data available.


Related in: MedlinePlus