Table 1.
Summary of recent meta-analyses evaluating the role of the serum tumor markers CA 19-9, CEA, and CA 72-4 in gastric cancer
| Marker; reference | Included studies (range) | Number of patients | Main findings | Conclusions | Limitations |
|---|---|---|---|---|---|
| CEA; Deng et al. [75], 2015 | 41 (1982–2014) | 14,651 | pretreatment serum CEA may be an independent prognostic factor in GC [OS: HR = 1.681, 95% CI 1.425–1.982; DSS: HR = 1.900, 95% CI 1.441–2.505; DFS: HR = 2.579, 95% CI 1.935–3.436] | CEA-positive patients with GC have a worse prognosis and intensive neoadjuvant therapy would be more beneficial compared with CEA-negative patients | significant heterogeneity among the studies |
| CA 19-9; Song et al. [45], 2015 | 38 [1995–2014] | 11,408 | serum CA 19-9 was significantly associated with poor OS [HR = 1.83, 95% CI 1.56–2.15], DFS [HR = 1.85, 95% CI 1.16–2.95], and DSS [HR = 1.33, 95% CI 1.10-1.60] in GC | CA 19-9 shows clinicopathologic characteristics of GC and is connected with poor prognosis | missing detailed individual information, significant heterogeneity, and lack of conclusive result for the optimal CA 19-9 cutoff value |
| CA 19-9; Xiao et al. [46], 2014 | 12 [2000–2013] | 5,072 | elevated serum CA 19-9 [>37 U/mL] was associated with poorer OS in patients with GC [fixed-effects HR = 1.36, 95% CI 1.24–1.48, p < 0.001] | CA 19-9 plays an important prognostic role in patients with GC | subgroup analysis by treatment method was not done and many retrospective cohort studies were included |
| CA 72-4; Chen et al. [93], 2012 | 33 [1999–2007] | 5,283 | positive serum CA 72-4 in GC patients had the highest OR [32.86, 95% CI 16.34–6.09] compared to controls; the sensitivity of CA 72-4 is limited, but CA 72-4 + CEA + CA 19-9 could improve sensitivity without affecting specificity | CA 72-4 or CA 72-4 + CEA + CA 19-9 could help in the diagnosis of GC | only a Chinese population was studied |
CA, carbohydrate antigen; CEA, carcinoembryonic antigen; CI, confidence interval; DFS, disease-free survival; DSS, disease-specific survival; GC, gastric cancer; HR, hazard ratio; OR, odds ratio; OS, overall survival.