Performance Of CA72-4 In The Diagnosis Of Gastric Carcinoma: A Sistematic Review And Meta-Analysis

Objectives Summarize existing evidence which compared CA72-4 diagnosis of gastric neoplasm with histopathology as the gold standard and then performed a Meta-analysis about this unique tumor marker with its potential diagnostic use and monitor in gastric cancer.Methods A comprehensive and systematic literature search was conducted in PubMed, Embase, Ovid database and Springer databases about serum CA72-4 in diagnosis gastric cancer between august 1985 and august 2010. After a systematic data extraction, quality assessment and qualified data synthesis, the sensitivity, specificity, area under the curve (AUC) and Q value for CA72-4 in the detection of gastric cancer were determined for included studies. SROC (summary receiver operating curves) were used to summarize the overall test performance.Results At last data were extracted from 15 articles involving 4476 participants (1401 gastric cancer patients and 3075 without cancer evidence all diagnosed by the histological gold standard) which met the inclusion criterion. The summary estimates for CA72-4 diagnosis gastric cancer were as follows: (1) for overall estimate, the pooled sensitivity was 0.47 (95% confidential interval , 0.44 to 0.49) and the pooled specificity was 0.95 (95% CI, 0.93 to 0.96); Diagnostic odds ratio was 17.32(95% CI, 12.64-23.74); AUC= 0.7816,Q* =0.7199. (2) For subgroup analysis in diagnosis of gastric cancer with metastases indicated a better diagnostic accuracy, the pooled sensitivity was 0.62 (95% CI, 0.57 to 0.67) and the pooled specificity was 0.95 (95% CI, 0.93 to 0.96); Diagnostic odds ratio was 34.94(95% CI, 22.63-53.95); AUC= 0. 9507,Q* =0.8914.Conclusions The performance of CA72-4 is moderate in the diagnosis of gastric cancer. Although serum level of CA72-4 has an excellent specificity in accurately diagnosing gastric cancer, especially in advance cancer or distal metastasis, the sensitivity is low. Further studies of CA72-4 in diagnosis of gastric cancer seem to be worthwhile.