The Relationship Between Endoscopy Results and Serum Tumor Marker Levels in Patients with Dyspepsia

Introduction Digestive disorders are common diseases and can be diagnosed as an easy and effective method by endoscopic examination. Endoscopy has become the most standard diagnostic method. The primary purpose of endoscopists is to diagnose or eliminate gastrointestinal cancer early and to present other gastrointestinal disorders. Carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), and alpha fetoprotein (AFP) are used as markers of gastrointestinal malignancies [1]. CA 19-9 and CEA are antigens related to most epithelial-derived cancers, including digestive cancers [2].

The serum tumor markers of ovarian cancer patients are usually rising. Examples of such markers include carcinoembryonic antigen, ovarian cystadenocarcinoma antigen and CA-125 tumor associated antigens. In advanced (stage III or IV) ovarian cancer patients, 82% of women showed elevated CA-125 (16), and in early-stage women, CA-125 also increased but infrequently. (17) Measurements performed prior to diagnostic laparoscopy showed that half of women with stage I tumors had elevated CA-125. (20) However, these cases do not represent asymptomatic women in the general population. Whether tumor markers rise sufficiently early in the natural history of latent ovarian cancer to provide adequate screening sensitivity is unknown.

Serum tumor markers such as prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) are generally elevated in prostate cancer patients, but they do not seem to be useful screening assays to detect preclinical disease . The reported PAP sensitivity is between 20% and 45%. (11, 19) PSA is very sensitive, but lacks specificity (about 38-56%) because it is difficult to distinguish between cancer and benign prostatic inflammation. (19, 20) There is little direct evidence that early detection of prostate cancer can improve outcomes. The survival rate of patients with early disease seems longer; the 5-year survival rate for phase A tumor is 85%, B phase is 77%, C phase is 65% and D phase is 29%. (21) However, it is unknown how much deviation between time and length occurs. Explain these differences