Stomach cancer laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Stomach cancer laboratory findings
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A complete blood cell count (CBC) can identify anemia, which is present in approximately 30% of patients and may be caused by bleeding, liver dysfunction, or poor nutrition
Electrolyte panels and liver function tests also are essential to better characterize the patient's clinical state
Carcinoembryonic antigen (CEA) is increased in 45-50% of cases
Cancer antigen (CA) 19-9 is elevated in about 20% of cases
Distinctive serum glycan patterns may have the potential to serve as markers for gastric cancer risk. In a study of 72 serum samples from patients with gastric cancer, nonatrophic gastritis, or duodenal ulcer, Ozcan and colleagues found that abnormal patterns of serum glycans (sugars attached to proteins) may be useful as a screening tool for identifying patients with Helicobacter pylori infection who are at risk for stomach cancer. [[null 30], [null 31]]
Serum levels of carcinoembryonic antigen (CEA), the glycoprotein CA 125 antigen (CA 125), CA 19-9 (carbohydrate antigen 19-9, also called cancer antigen 19-9), and cancer antigen 72-4 (CA72 4) may be elevated in patients with gastric cancer [68-72].
However, low rates of sensitivity and specificity prevent the use of any of these serologic markers as diagnostic tests for gastric cancer.
In a minority of patients, a drop in an elevated level of CEA and/or CA 125 may correlate with response to preoperative therapy, but clinical decisions are almost never made based upon tumor marker changes alone.
Some gastric cancers are associated with elevated serum levels of alpha-fetoprotein (AFP);
they are referred to as alpha-fetoprotein producing gastric cancers [85-88]. A subset, hepatoid adenocarcinomas of the stomach, has a histologic appearance that is similar to that of hepatocellular cancer (HCC). Regardless of morphology, AFP-producing gastric cancers are aggressive and associated with a poor prognosis.
Increases in serum pepsinogen II or decreases in the pepsinogen I:pepsinogen II ratio has been used in population screening programs to identify patients at increased risk for gastric cancer but are insufficiently sensitive or specific for establishing a diagnosis in an individual patient.
A total of 19 significant differences in serum glycan expression were found between gastric cancer patients and individuals with asymptomatic nonatrophic gastritis. High-mannose–type glycans, glycans with 1 complex type antenna, and bigalactosylated biantennary glycans tended to be lower in gastric cancer patients, whereas levels of nongalactosylated biantennary glycans were higher. Altered serum glycan levels were also seen in study patients with ulcers. [[null 30], [null 31]]