Diagnostic and economic value of carcinoembryonic antigen, carbohydrate antigen 19-9, and carbohydrate antigen 72-4 in gastrointestinal cancers

Sep 24, 2026

Retrospective analysis reassessed the diagnostic and economic value of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4 in gastrointestinal malignant tumors, addressing limited large-scale evaluation. Data covered 32,857 subjects who underwent CEA, CA19-9, CA72-4 testing plus gastroscopy and colonoscopy from October 2006 to May 2018. Discrimination, clinical usefulness, and economic impact were compared using diagnostic efficiencies and cost-effectiveness indicators across two endoscopy strategies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages26

Reading Time1 h 6 min

AccessFree to download

Background

Aim

Methods

Results

Conclusion

Key Words

| W | J | G | World Journal of
Gastroenterology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2023 January 28; 29(4): 706-730 DOI: 10.3748/wjg.v29.i4.706 ISSN 1007-9327 (print) ISSN 2219-2840 (online) ORIGINAL ARTICLE Retrospective Study Diagnostic and economic value of carcinoembryonic antigen, carbohydrate antigen 19-9, and carbohydrate antigen 72-4 in gastrointestinal cancers Hai-Ning Liu, Can Yao, Xiao-Fan Wang, Ning-Ping Zhang, Yan-Jie Chen, Dong Pan, Guo-Ping Zhao, Xi-Zhong Shen, Hao Wu, Tao-Tao Liu Specialty type: Gastroenterology and hepatology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s scientific quality classification Grade A (Excellent): 0 Grade B (Very good): B, B Grade C (Good): 0 Grade D (Fair): 0 Grade E (Poor): 0 P-Reviewer: Dauyey K, Kazakhstan; Grossi U, Italy Received: September 18, 2022 Peer-review started: September 18, 2022 First decision: November 15, 2022 Revised: November 28, 2022 Accepted: December 21, 2022 Article in press: December 21, 2022 Published online: January 28, 2023 Hai-Ning Liu, Xiao-Fan Wang, Ning-Ping Zhang, Yan-Jie Chen, Xi-Zhong Shen, Hao Wu, Tao-Tao Liu, Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China Can Yao, Department of Gastroenterology and Hepatology, Minhang District Central Hospital, Fudan University, Shanghai 201199, China Dong Pan, Department of Internet Technology Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China Guo-Ping Zhao, Chinese National Human Genome Center at Shanghai, Zhujiang Hospital, Central Lab, Institute of Plant Physiology and Ecology, Shanghai Institute for Biological Sciences, Shanghai 200032, China Corresponding author: Tao-Tao Liu, MD, Doctor, Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai 200032, [China.](China. liu.taotao@zs-hospital.sh.cn)[ liu.taotao@zs-hospital.sh.cn](China. liu.taotao@zs-hospital.sh.cn) Abstract BACKGROUND The diagnostic and economic value of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA72-4 for gastrointestinal malignant tumors lacked evaluation in a larger scale. AIM To reassess the diagnostic and economic value of the three tumor biomarkers. METHODS A retrospective analysis of all 32857 subjects who underwent CEA, CA19-9, CA72- 4, gastroscopy and colonoscopy from October 2006 to May 2018 was conducted. Then, we assessed the discrimination and clinical usefulness. Total cost, cost per capita and cost-effectiveness ratios were used to evaluate the economic value of two schemes (gastrointestinal endoscopy for all people without blood tests vs both gastroscopy and colonoscopy when blood tests were positive) . WJG [https://www.wjgnet.com](https://www.wjgnet.com) 706 January 28, 2023 Volume 29 Issue 4 Liu HN et al. Tumor biomarkers for gastrointestinal cancers RESULTS The analysis of 32857 subjects showed that CEA was a qualified biomarker for colorectal cancer (CRC), while the diagnostic efficiencies of CA72-4 were catastrophic for all gastrointestinal cancers (GICs) . Regarding early diagnosis, only CEA could be used for early CRC. The combination of biomarkers didn’t greatly increase the area under the curve. The economic indicators of CEA were superior to those of CA19-9, CA72-4 and any combination. At the threshold of 1.8 μg/L to 10.4 μg/L, all four indicators of CEA were lower than those in the scheme that conducted gastrointestinal endoscopy only. Subgroup analysis implied that the health checkup of CEA for people above 65 years old was economically valuable. CONCLUSION CEA had qualified diagnostic value for CRC and superior economic value for GICs, especially for elderly health checkup subjects. CA7

FAQs

What question does this study address?

It reassesses the diagnostic and economic value of CEA, CA19-9, and CA72-4 for gastrointestinal malignant tumors on a larger scale.

How was the study conducted and what data were analyzed?

A retrospective analysis evaluated 32,857 subjects who had blood tests (CEA, CA19-9, CA72-4) and underwent gastroscopy and colonoscopy from October 2006 to May 2018.

What were the key diagnostic and economic findings?

CEA showed qualified diagnostic value for colorectal cancer and superior economic value for gastrointestinal cancers, while CA72-4 was not suitable as a diagnostic biomarker. Economic indicators for CEA outperformed CA19-9, CA72-4, and combinations.

Sep 24, 2026

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