Clinical significance and diagnostic capacity of serum TK1, CEA, CA 19-9 and CA 72-4 levels in gastric and colorectal cancer patients

Shufang Ning, Wene Wei, Jilin Li, Bingbing Hou, Jianhong Zhong, Yuxuan Xie, Haizhou Liu, Xianwei Mo, Jiansi Chen, Litu Zhang, Shufang Ning, Wene Wei, Jilin Li, Bingbing Hou, Jianhong Zhong, Yuxuan Xie, Haizhou Liu, Xianwei Mo, Jiansi Chen, Litu Zhang

Abstract

Despite extensive progress in treatment for cancer in recent decades, the early diagnosis for gastric cancer (GC) and colorectal cancer (CRC) remains poor. In this study, we explore the diagnostic value of joint detection of thymidine kinase 1 (TK1), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9) and carbohydrate antigen 72-4 (CA 72-4) in the diagnosis of GC and CRC, and to evaluated the relationship between TK1 expression and clinical pathological characteristics in the patients. Serum TK1, CA 19-9, CA 72-4 and CEA levels were measured in 169 patients with GC, 344 patients with CRC and 75 healthy controls using electro-chemiluminescence. The TK1 concentration was significantly higher in patients with cancer than in healthy controls and patients with clinical stage Ⅲ+Ⅳ had higher TK1 levels than clinical stage Ⅰ+Ⅱ (P<0.05). The levels of TK1 is significantly associated with tumor stage, lymph node metastasis, distant metastasis, tumor differentiation and age (P<0.05). When the tumor markers (TK1, CA 19-9 and CA 72-4) were detected respectively, the area under receiver operating characteristics curve (AUC) of TK1 for three cancers was the highest (0.823-0.895). However, the combination of AUC was higher than that for each tumor marker detected respectively (0.934-0.953), and the Hosmer-Lemeshow test showed an adequate model of calibration (P>0.05). Moreover, the AUCs varied significantly between the combination tests and single biomarker tests (Z test, P<0.01). In conclusion, serum TK1 may be an independent tumor marker for GC and CRC patients, and the combination of TK1, CA 19-9 and CA 72-4 and CEA performed even better. This study suggests that combination detection of four tumor markers may prove to be useful for the diagnosis of GC and CRC.

Keywords: CA 19-9; CA 72-4; CEA.; TK1; colorectal cancer; gastric cancer.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Positive rate of serum tumor markers in gastric and colorectal cancer according to tumor stage.
Figure 2
Figure 2
Box plot of distribution of TK1 in serum in three cancers (gastric, colon and rectal cancer) and healthy controls. The center line and box represent the median and interquartile ranges, respectively. The values of the maximum and minimum, eliminating outliers, are represented by the vertical lines. *P<0.05.
Figure 3
Figure 3
ROC curves of single TK1, CA 19-9, CA 72-4, CEA and the combination in predicting gastric cancer (A), colon cancer (B) and rectal cancer (C)

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