Oesophageal cancer, one of the leading causes of cancer death worldwide, is usually diagnosed at a late stage. Although carcinoembryonic antigen (CEA) and plasma DNA are known to be elevated in patients with oesophageal cancer and are higher in patients with metastatic disease, the sensitivity and specificity of these markers in the diagnosis of recurrent cancer has not been compared.
"The diagnosis of metastatic oesophageal cancer prior to surgery and recurrent disease after surgery remains challenging, as the clinical staging of oesophageal cancer is difficult and current scanning technologies are limited," said Farzaneh Banki, MD, assistant professor of surgery, Department of Surgery, Keck School of Medicine at the University of California, Los Angeles. "The results of our study suggest that measuring DNA levels could improve the diagnosis of and prediction of recurrence of this disease."
The study analyzed the sensitivity and specificity of plasma DNA as a preoperative marker of metastasized disease and a postoperative marker in residual or recurrent esophageal cancer. Plasma DNA was measured in 45 patients with esophageal cancer and 44 healthy volunteers; serum CEA was measured in 31 patients.
Plasma DNA was found to be more sensitive than CEA for detecting cancer that cannot be removed through a surgical procedure (100 percent versus 40 percent) and was also more sensitive than CEA in detecting recurrent esophageal cancer (100 percent versus 33 percent). All patients with recurrent disease had elevated plasma DNA, and no patient with normal plasma DNA had recurrent disease. Plasma DNA rose before there was clinical evidence of recurrence in 67 percent of patients, versus 17 percent of patients measured for CEA.
MEDICA.de; Source: Weber Shandwick Worldwide