Normal and abnormal values ​​of tumor marker CA 72-4

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Stomach cancer is one of the most common types of cancer today. However, the clinical symptoms of gastric cancer are often vague, poor, and nonspecific. CA 72-4 is one of the important gastric cancer marker tests, very valuable in predicting the risk of gastric cancer.

1. How much CA 72-4 is normal?

CA 72-4 is an antigen produced by cells in the body, especially in the stomach CA 72-4 is produced more than other sites. Therefore, there is always a certain amount of CA 72-4 in the blood.
Quantification of CA 72-4 lower than 6.9 μg/ml is normal. In some cases, CA 72-4 levels may be slightly elevated in people who smoke or use drugs.

2. How high is the CA 72-4?

Many people believe that a higher than normal level of CA 72-4 in the blood is definitely a sign of stomach cancer. This view is completely wrong. In fact, CA 72-4 can be increased even in some benign diseases such as: pancreatitis (3%), cirrhosis (4%), lung disease (17-19%), joint disease (21%). ), adnexal diseases (0-10%), benign ovarian diseases (3-4%), ovarian cysts (25%), mammary gland diseases (10%), benign gastrointestinal diseases (5% ).
The specificity of CA 72-4 is 60%, which means that in 100 people with stomach cancer, only 60 people will have elevated CA 72-4 blood levels. Therefore, a single CA 72-4 elevation above normal does not confirm gastric cancer, but further examination is needed to rule out such malignancy. However, when CA 72-4 is combined with some other cancer markers such as CEA or CA 19-9 is increased (normal: CEA: < 5 ng/ml, CA19-9 < 37 U/ml), the risk is increased. The risk of stomach cancer also increased significantly.
In gastric cancer, the CA 72-4 concentration is higher than the normal value as follows:
In the early stage: the CA 72-4 level rises above 6 UI/l. This increase is not diagnostically significant; In the full-blown stage, the CA 72-4 concentration is elevated, in some cases, the CA 72-4 level is increased over 100 UI/l.

3. How high is the CA 72-4?

CA 72-4 level is elevated in some cancers:
3.1 CA 72-4 is increased in stomach cancer The rate of CA 72-4 is increased in stomach cancer is 28-80%, common in 40-46% of cancer cases.
Role of CA 72-4 when monitoring response to gastric cancer treatment: preoperative CA 72-4 level has the best prognostic value to indicate progression of gastric cancer. The combination of preoperative CA 72-4, CA 19-9 and CEA levels of cancer markers will provide additional prognostic information for gastric cancer. Patients with one of these cancer markers positive are considered to be at high risk of recurrence, even at an early stage. After gastric tumor removal surgery, CA 72-4 levels should return to normal in about 1-2 weeks after surgery; Role of CA 72-4 in the assessment of recurrence after gastric cancer treatment: after gastric bypass surgery, if recurrence occurs, the level of CA 72-4 will increase in 70% of cases, while CA level 19-9 increased only in 50% and CEA increased only in 20% of relapse cases. 3.2 CA 72-4 increased in ovarian cancer Sensitivity of CA 72-4 in the diagnosis of ovarian cancer is 47-80%, in stage I - II is 10%, in stage III - IV is 56%. The clinical sensitivity of CA 72-4 in mucinous ovarian cancer is higher than that of the CA125 marker.
In ovarian cancer that has recurred after surgery, CA 72-4 is increased in 40% of cases, while CA 125 is increased in 60% of cases. When these two markers are combined, the clinical sensitivity in ovarian cancer increases from 60% (for CA 125 alone) to 73% for cancer diagnosis and from 60% to 67% for detection. recurrence of ovarian tumours.
3.3 CA 72-4 increase in colorectal cancer The rate of CA 72-4 increase in colorectal cancer is 20-41%. About 18 days after surgery to completely remove a colorectal tumor, levels of the cancer marker will decrease, but when surgically removing part of the tumor, CA 72-4 levels do not decrease. Thus, during follow-up, the CA 72-4 level still increases or increases, indicating that the tumor is still there and usually increases in 78% of cases of tumor recurrence, in 39% of cases of localized tumors. .
When combined with CEA, the sensitivity of CA 72-4 increased from 43% to 60% for the initial diagnosis of colorectal cancer and from 78% to 87% for the diagnosis of postoperative recurrence.
3.4 CA 72-4 is increased in other gastrointestinal cancers CA 72-4 level is increased in 35 - 52% of patients with cholangiocarcinoma, 17 - 35% of patients with pancreatic cancer and only in 4 - 25% of patients with esophageal cancer. However, increased cancer marker CA 19-9 would be more significant than CA 72-4 in these cancers.
3.5 CA 72-4 increased in other adnexal cancers

Levels of the CA 72-4 marker were increased in 54% of patients with endometrial cancer, in 24% of patients with breast cancer, and only in 14% of patients with cervical cancer.
From the above information, it can be concluded:
CA 72-4 is a mucin-glycoprotein present on the surface of many cell types such as ovarian, breast, colon, pancreatic cells, especially cancer cells. gastric epithelium; CA 72-4 is used to monitor treatment response and recurrence of gastric cancer, and is also used to diagnose ovarian cancer. CA 72-4 is indicated as a type 1 tumor marker to monitor treatment response and recurrence of gastric cancer, and as a type 2 tumor marker for the diagnosis of mucinous ovarian cancer; When gastric cancer is suspected, besides CA 72-4 testing, other tests must be done to confirm the diagnosis; CA 72-4 levels may be elevated in certain malignancies such as gastric, ovarian, colorectal, some gastrointestinal or other adnexal cancers. It can also be increased in some benign diseases.

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