Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Molecular and Clinical Oncology
Join Editorial Board Propose a Special Issue
Print ISSN: 2049-9450 Online ISSN: 2049-9469
Journal Cover
January-February 2013 Volume 1 Issue 1

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
January-February 2013 Volume 1 Issue 1

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article

Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment

  • Authors:
    • Xin Li
    • Jun Lu
    • Hui Ren
    • Tianjun Chen
    • Lin Gao
    • Ligai Di
    • Zhucui Song
    • Ying Zhang
    • Tian Yang
    • Asmitananda Thakur
    • Shu-Feng Zhou
    • Yanhai Yin
    • Mingwei Chen
  • View Affiliations / Copyright

    Affiliations: Department of Respiratory Medicine, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China, School of Interdisciplinary Health Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1142, New Zealand, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
  • Pages: 153-160
    |
    Published online on: September 19, 2012
       https://doi.org/10.3892/mco.2012.23
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

The present study aimed to assess the diagnostic/prognostic value of various clinical tumor markers, including carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin 19 (CYFRA21-1), α-fetoprotein (AFP), carbohydrate antigen-125 (CA-125), carbohydrate antigen-19.9 (CA-19.9) and ferritin, individually or in combination. The electro-chemiluminescence immunization method was performed to detect the levels of seven tumor markers in 560 cancer patients and 103 healthy subjects for comparison. The serum levels of the seven markers measured in cancer patients were higher compared to healthy subjects (P<0.05 for AFP and P<0.001 for the remaining six markers). Different markers had different sensitivity towards different types of tumors. Combining more markers significantly increased the ratios of positive diagnosis in the tumors. The diagnostic sensitivities of combining seven markers were particularly high in digestive, urinary and skeletal tumors (82, 92 and 83%, respectively). Gynecological tumors have exhibited a constant yet relatively low positive diagnosis irrespective of the use of a single marker or combined markers. However, the increase in sensitivity when combining markers was accompanied by a decrease in specificity. Generally, combining more markers increased the tumor detection rates, while a combination of the seven markers provided the highest detection rate. Combined detection showed a particularly high sensitivity in detecting respiratory, digestive and urinary system tumors, with the lowest sensitivity observed in gynecological tumors. As a result, combining tumor markers may play an important role in early tumor detection/diagnosis while the loss of specificity can be tolerated.
View Figures
View References

1. 

Welch HG, Schwartz LM and Woloshin S: Are increasing 5-year survival rates evidence of success against cancer? JAMA. 283:2975–2978. 2000.

2. 

Bates SE and Longo DL: Use of serum tumor markers in cancer diagnosis and management. Semin Oncol. 14:102–138. 1987.

3. 

Kluger HM, Hoyt K, Bacchiocchi A, et al: Plasma markers for identifying patients with metastatic melanoma. Clin Cancer Res. 17:2417–2425. 2011.

4. 

Cohn SL, Lincoln ST and Rosen ST: Present status of serum tumor markers in diagnosis, prognosis, and evaluation of therapy. Cancer Invest. 4:305–327. 1986.

5. 

Virji MA, Mercer DW and Herberman RB: Tumor markers in cancer diagnosis and prognosis. CA Cancer J Clin. 38:104–126. 1988.

6. 

Maxwell P: Carcinoembryonic antigen: cell adhesion molecule and useful diagnostic marker. Br J Biomed Sci. 56:209–214. 1999.

7. 

Molina R, Filella X, Auge JM, et al: Tumor markers (CEA, CA 125, CYFRA 21-1, SCC and NSE) in patients with non-small cell lung cancer as an aid in histological diagnosis and prognosis. Comparison with the main clinical and pathological prognostic factors. Tumour Biol. 24:209–218. 2003.

8. 

Hammarstrom S: The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues. Semin Cancer Biol. 9:67–81. 1999.

9. 

Tan E, Gouvas N, Nicholls RJ, et al: Diagnostic precision of carcinoembryonic antigen in the detection of recurrence of colorectal cancer. Surg Oncol. 18:15–24. 2009.

10. 

Carney DN and Teeling M: Neuron-specific enolase: how useful as a cancer marker? Eur J Cancer Clin Oncol. 24:825–828. 1988.

11. 

Hatzakis KD, Froudarakis ME, Bouros D, et al: Prognostic value of serum tumor markers in patients with lung cancer. Respiration. 69:25–29. 2002.

12. 

Cooper EH: Neuron-specific enolase. Int J Biol Markers. 9:205–210. 1994.

13. 

Saloustros E and Mavroudis D: Cytokeratin 19-positive circulating tumor cells in early breast cancer prognosis. Future Oncol. 6:209–219. 2010.

14. 

Uenishi T, Kubo S, Hirohashi K, et al: Cytokeratin-19 fragments in serum (CYFRA 21-1) as a marker in primary liver cancer. Br J Cancer. 88:1894–1899. 2003.

15. 

Stieber P, Hasholzner U, Bodenmuller H, et al: CYFRA 21-1: a new marker in lung cancer. Cancer. 72:707–713. 1993.

16. 

Jain R, Fischer S, Serra S, et al: The use of cytokeratin 19 (CK19) immunohistochemistry in lesions of the pancreas, gastrointestinal tract, and liver. Appl Immunohistochem Mol Morphol. 18:9–15. 2010.

17. 

Groover JR and Rogers AI: Immunologic tests for the detection of gastrointestinal cancers: status report on carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP). Southern Med J. 66:1218–1221. 1973.

18. 

Chen L, Ho DW, Lee NP, et al: Enhanced detection of early hepatocellular carcinoma by serum SELDI-TOF proteomic signature combined with alpha-fetoprotein marker. Ann Surg Oncol. 17:2518–2525. 2010.

19. 

Kemer T, Ormen M, Kuralay F, et al: Diagnostic usefulness of carbohydrate antigen-125 in cancerous and noncancerous peritoneal effusions. Tohoku J Exp Med. 205:11–18. 2005.

20. 

Oktay G, Guner G, Karlikaya C and Akkoclu A: Serum levels of neuron-specific enolase, carbohydrate antigen 19-9 and carbohydrate antigen 125 in carcinoma of the lung. Biochem Soc Trans. 23:211S1995.

21. 

Yeh LS, Hung YC, Kao A, et al: Tissue polypeptide specific antigen (TPS) and carbohydrate antigen 125 (CA-125) in the early prediction of recurrent ovarian cancer. Anticancer Res. 22:3669–3671. 2002.

22. 

Encabo G, Genolla J, Gefaell R and Ruibal A: Serum carbohydrate antigen 19.9 in patients with digestive cancers. Presse Med. 14:23041985.(In French).

23. 

Halloran CM, Ghaneh P, Connor S, et al: Carbohydrate antigen 19.9 accurately selects patients for laparoscopic assessment to determine resectability of pancreatic malignancy. Br J Surg. 95:453–459. 2008.

24. 

van Ruth S, Hart AA, Bonfrer JM, et al: Prognostic value of baseline and serial carcinoembryonic antigen and carbohydrate antigen 19.9 measurements in patients with pseudomyxoma peritonei treated with cytoreduction and hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol. 9:961–967. 2002.

25. 

Torti SV and Torti FM: Iron and ferritin in inflammation and cancer. Adv Inorg Biochem. 10:119–137. 1994.

26. 

Richardson DR: Iron and neoplasia: serum transferrin receptor and ferritin in prostate cancer. J Lab Clin Med. 144:173–175. 2004.

27. 

Slodkowska J, Szturmowicz M, Rudzinski P, et al: Expression of CEA and trophoblastic cell markers by lung carcinoma in association with histological characteristics and serum marker levels. Eur J Cancer Prev. 7:51–60. 1998.

28. 

Bergman B, Brezicka FT, Engstrom CP and Larsson S: Clinical usefulness of serum assays of neuron-specific enolase, carcinoembryonic antigen and CA-50 antigen in the diagnosis of lung cancer. Eur J Cancer. 29A:198–202. 1993.

29. 

Seemann MD, Seemann O, Dienemann H, Schalhorn A, Prime G and Fink U: Diagnostic value of chest radiography, computed tomography and tumour markers in the differentiation of malignant from benign solitary pulmonary lesions. Eur J Med Res. 4:313–327. 1999.

30. 

Schneider J and Schulze G: Comparison of tumor M2-pyruvate kinase (tumor M2-PK), carcinoembryonic antigen (CEA), carbohydrate antigens CA 19-9 and CA 72-4 in the diagnosis of gastrointestinal cancer. Anticancer Res. 23:5089–5093. 2003.

31. 

Buccheri G, Torchio P and Ferrigno D: Clinical equivalence of two cytokeratin markers in non-small cell lung cancer: a study of tissue polypeptide antigen and cytokeratin 19 fragments. Chest. 124:622–632. 2003.

32. 

Sung HJ and Cho JY: Biomarkers for the lung cancer diagnosis and their advances in proteomics. BMB Rep. 41:615–625. 2008.

33. 

Muraki M, Tohda Y, Iwanaga T, Uejima H, Nagasaka Y and Nakajima S: Assessment of serum CYFRA 21-1 in lung cancer. Cancer. 77:1274–1277. 1996.

34. 

Gaspar MJ, Arribas I, Coca MC and Diez-Alonso M: Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in gastric carcinoma. Tumour Biol. 22:318–322. 2001.

35. 

Pujol JL, Boher JM, Grenier J, Quantin X, Saffont L and Daures JP: Neuron-specific enolase (NSE) in the surveillance of small cell cancers: an evaluation of the prognostic information using Markov’s model. Rev Mal Respir. 15:519–525. 1998.(In French).

36. 

Chou SF and Chen CY: Monoclonal and polyclonal antibodies against human ferritin, a nonspecific tumor marker. Hybridoma. 20:59–62. 2001.

37. 

Aulbert E and Schmidt CG: Ferritin - a tumor marker in myeloid leukemia. Cancer Detect Prev. 8:297–302. 1985.

38. 

Dorner MH, Abel U, Fritze D, Manke HG and Drings P: Serum ferritin in relation to the course of Hodgkin’s disease. Cancer. 52:2308–2312. 1983.

39. 

Bekci TT, Senol T and Maden E: The efficacy of serum carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in determining the malignancy of solitary pulmonary nodules. J Int Med Res. 37:438–445. 2009.

40. 

Wu GP, Ba J, Zhao YJ and Wang EH: Diagnostic value of CEA, CYFRA 21-1, NSE and CA 125 assay in serum and pleural effusion of patients with lung cancer. Acta Cytol. 51:679–680. 2007.

41. 

Donach M, Yu Y, Artioli G, et al: Combined use of biomarkers for detection of ovarian cancer in high-risk women. Tumour Biol. 31:209–215. 2010.

42. 

Goldenberg DM, Sharkey RM and Primus FJ: Immunocytochemical detection of carcinoembryonic antigen in conventional histopathology specimens. Cancer. 42:1546–1553. 1978.

43. 

Nunez GR, Ito C and Del Giglio A: Increased serum CA-125 levels in patients with lung cancer post thoracotomy. Southern Med J. 102:427–428. 2009.

44. 

Beneduce L, Castaldi F, Marino M, et al: Improvement of liver cancer detection with simultaneous assessment of circulating levels of free alpha-fetoprotein (AFP) and AFP-IgM complexes. Int J Biol Markers. 19:155–159. 2004.

45. 

Beale G, Chattopadhyay D, Gray J, et al: AFP, PIVKAII, GP3, SCCA-1 and follisatin as surveillance biomarkers for hepatocellular cancer in non-alcoholic and alcoholic fatty liver disease. BMC Cancer. 8:2002008.

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Li X, Lu J, Ren H, Chen T, Gao L, Di L, Song Z, Zhang Y, Yang T, Thakur A, Thakur A, et al: Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment. Mol Clin Oncol 1: 153-160, 2013.
APA
Li, X., Lu, J., Ren, H., Chen, T., Gao, L., Di, L. ... Chen, M. (2013). Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment. Molecular and Clinical Oncology, 1, 153-160. https://doi.org/10.3892/mco.2012.23
MLA
Li, X., Lu, J., Ren, H., Chen, T., Gao, L., Di, L., Song, Z., Zhang, Y., Yang, T., Thakur, A., Zhou, S., Yin, Y., Chen, M."Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment". Molecular and Clinical Oncology 1.1 (2013): 153-160.
Chicago
Li, X., Lu, J., Ren, H., Chen, T., Gao, L., Di, L., Song, Z., Zhang, Y., Yang, T., Thakur, A., Zhou, S., Yin, Y., Chen, M."Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment". Molecular and Clinical Oncology 1, no. 1 (2013): 153-160. https://doi.org/10.3892/mco.2012.23
Copy and paste a formatted citation
x
Spandidos Publications style
Li X, Lu J, Ren H, Chen T, Gao L, Di L, Song Z, Zhang Y, Yang T, Thakur A, Thakur A, et al: Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment. Mol Clin Oncol 1: 153-160, 2013.
APA
Li, X., Lu, J., Ren, H., Chen, T., Gao, L., Di, L. ... Chen, M. (2013). Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment. Molecular and Clinical Oncology, 1, 153-160. https://doi.org/10.3892/mco.2012.23
MLA
Li, X., Lu, J., Ren, H., Chen, T., Gao, L., Di, L., Song, Z., Zhang, Y., Yang, T., Thakur, A., Zhou, S., Yin, Y., Chen, M."Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment". Molecular and Clinical Oncology 1.1 (2013): 153-160.
Chicago
Li, X., Lu, J., Ren, H., Chen, T., Gao, L., Di, L., Song, Z., Zhang, Y., Yang, T., Thakur, A., Zhou, S., Yin, Y., Chen, M."Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment". Molecular and Clinical Oncology 1, no. 1 (2013): 153-160. https://doi.org/10.3892/mco.2012.23
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team