Comparison of serum cytokeratin-18, CEA and CA 19-9 levels in esophageal and gastric cancers

The aim of this study was to determine clinical value of alone and combined use of serum cytokeratin (CK)-18, carcinoembryonic antigen (CEA) and CA 19-9 in esophageal squamous cell carcinoma and gastric adenocarcinoma. Serum tumor markers were measured in 60 patients who had esophageal squamous cell carcinoma or gastric adenocarcinoma. Thirty healthy subjects served as controls. In patients with gastric adecarcinoma serum CK-18 levels were significantly increased compared to both esophageal squamus cell carcinoma and control groups (p<0.01, p<0,05 respectively). But there was no significant difference in CK-18 levels between esophageal squamous cell carcinoma patients and healthy subjects (p>0.05). On the other hand, serum CEA and CA 19-9 levels did not differ between groups (p>0.05). The sensitivity of serum CK-18, CEA and CA19- 9 in esophageal squamous cell carcinoma were 53%, 70% and 66%, respectively. For gastric adenocarcinoma, the sensitivity of each tumor marker was similar 70%, 70% and 70%, respectively. CK-18/CA19-9 combination in the esophageal (83%) and gastric carcinomas (93%) were found to be more sensitive than other tumor markers when these markers were evaluated in combination. CEA exhibited the highest sensitivity for esophageal squamous cell carcinoma compared to CK-18, and CA19-9. However, the sensitivity of all tumor markers in gastric adenocarcinoma were similar. The combination of CK-18 and CA19-9 could increase the diagnostic sensitivity in esophageal and gastric carcinomas.