The diagnostic, prognostic and monitoring value of CA 72.4 in gastric cancer was prospectively studied, in parallel with CA 19.9 and CEA. Thirty-eight patients with primary gastric carcinoma were included in a prospective two-year study. The mean values of CA 72.4 and CA 19.9 before surgery were statistically different from those of a control group (n = 38) with benign gastro-intestinal (GI) diseases. CA 72.4 adds independent complementary sensitivity to CEA and CA 19.9. According to the ROC analysis, the highest area under the ROC curve was that of CA 72.4 (0.75 ± 0.06), followed by CA 19.9 (0.64 ± 0.07) and CEA (0.53 ± 0.07). Using the “kinetic profile” index, prognostic studies revealed significant correlations between CEA (at days 0, 7 and 14) and overall survival. In the patients with no evidence of disease nor progression, the true negative rate of CA 72.4 was higher (100 %) than that of CEA (86.7 %) and CA 19.9 (73.3 %) ; the false positive rate was 0 %, 13.3 % and 26.7 % for CA 72.4, CEA and CA 19.9, respectively, and highlighting the absolute specificity of CA 72.4.
A higher true positive rate for detecting progressive disease or recurrence was noted for CA 72.4 (81.6 %) than for CEA (54.5 %) and CA 19.9 (45.5 %). CA 72.4 may constitute a useful test assisting in the clinical management of gastric cancer patients.