Journal of Tumour Research & Reports

Early Detection and Improved Outcomes: Exploring Tumour Markers in Gastrointestinal Cancers

Cihan Sorrenti^* Department of Molecular Oncology, University of Health Sciences, Istanbul, Turkey
^*Correspondence: Cihan Sorrenti, Department of Molecular Oncology, University of Health Sciences, Istanbul, Turkey, Email:

Received: 24-May-2023, Manuscript No. JTRR-23-22035; Editor assigned: 26-May-2023, Pre QC No. JTRR-23-22035 (PQ); Reviewed: 12-Jun-2023, QC No. JTRR-23-22035; Revised: 20-Jun-2023, Manuscript No. JTRR-23-22035 (R); Published: 28-Jun-2023, DOI: 10.35248/2684-1614.23.8.191

Description

Gastrointestinal malignancies, including cancers of the oesophagus, stomach, liver, pancreas, colon, and rectum, are a significant global health burden. Early detection and accurate diagnosis are critical for improving patient outcomes in these malignancies. Tumour markers, specific substances produced by cancer cells, have emerged as valuable tools in the management of gastrointestinal malignancies. They can aid in screening, diagnosis, prognosis, and monitoring treatment response. This article explores the various tumour markers used in gastrointestinal malignancies and their utility for clinicians.

Tumour markers and their significance

Tumour markers are molecules released by cancer cells or normal cells in response to the presence of cancer. While they are not exclusive to malignancies and can be elevated in other non-cancerous conditions, their measurement provides valuable clinical information. In gastrointestinal malignancies, several tumour markers have been identified and extensively studied.

Carcino-Embryonic Antigen (CEA): CEA is one of the most well-known tumour markers in gastrointestinal malignancies, particularly colorectal cancer. Elevated CEA levels can indicate disease presence, recurrence, or metastasis. However, CEA lacks specificity and sensitivity for early detection and may also be elevated in non-malignant conditions, limiting its use as a screening tool.

Alpha-Fetoprotein (AFP): AFP is primarily associated with Hepatocellular Carcinoma (HCC), the most common primary liver malignancy. Elevated AFP levels can help diagnose HCC, monitor treatment response, and detect recurrence. It is also used to assess the risk of developing HCC in patients with chronic liver disease. However, AFP levels can be elevated in non-malignant liver conditions, and its diagnostic accuracy may vary.

CA 19-9: CA 19-9 is commonly used in pancreatic cancer. Elevated CA 19-9 levels are associated with advanced disease, poor prognosis, and treatment response. However, CA 19-9 may not be elevated in all pancreatic cancer cases, limiting its sensitivity. Additionally, it can be elevated in non-malignant conditions, including benign biliary tract diseases.

CA 72-4: CA 72-4 is a tumour marker used in gastric cancer. It can aid in diagnosis, staging, monitoring response to therapy, and detecting recurrence. Elevated CA 72-4 levels correlate with advanced disease and poorer prognosis. However, its sensitivity and specificity are not optimal for early detection or screening purposes.

CA 125: CA 125 is primarily associated with ovarian cancer but can also be elevated in gastrointestinal malignancies, including gastric and colorectal cancer. Its levels can assist in diagnosing and monitoring treatment response, especially in advanced stages. However, CA 125 lacks sensitivity and specificity for early detection and may be elevated in non-cancerous conditions.

Human Chorionic Gonadotropin (HCG): HCG is typically associated with gestational trophoblastic diseases but can also be elevated in certain gastrointestinal malignancies, such as gastric and colorectal cancer. Its utility as a tumour marker in gastrointestinal malignancies is still being investigated, and further research is needed to establish its clinical significance.

Clinical applications of tumour markers

Screening and early detection of tumour markers are not typically recommended as stand-alone screening tools for gastrointestinal malignancies, they can be useful in specific contexts. For instance, CEA is recommended for postoperative surveillance in colorectal cancer patients, aiding in the early detection of recurrences. Additionally, some tumour markers, such as AFP, can be utilized in high-risk populations to identify early-stage liver cancers.

Diagnosis and differential diagnosis

Tumour markers play a valuable role in the diagnosis of gastrointestinal malignancies. For example, AFP is crucial in distinguishing hepatocellular carcinoma from other liver lesions. CA 19-9 and CA 72-4 are used in the diagnosis of pancreatic and gastric cancers, respectively. However, it is important to note that tumour markers are not specific enough to confirm a diagnosis on their own and should be used in conjunction with other diagnostic modalities.

Prognosis and treatment monitoring

Tumour markers provide valuable prognostic information and aid in monitoring treatment response. Elevated levels of certain markers, such as CEA, CA 19-9, and CA 72-4, correlate with advanced disease stages and poorer outcomes. Periodic measurement of tumour marker levels during treatment allows clinicians to assess response and detect disease progression or recurrence at an early stage.

Predicting therapeutic response

Tumour markers can also assist in predicting treatment response, especially in targeted therapies. For example, EGFR mutation status in colorectal cancer can help predict the response to EGFR inhibitors. Similarly, HER2 status in gastric cancer can guide the use of HER2-targeted therapies. Tumour markers can aid in selecting patients who are likely to benefit from specific treatments and avoid unnecessary side effects.

Tumour markers have become important tools in the management of gastrointestinal malignancies. While they have limitations and should not be used in isolation, their measurement provides valuable clinical information in screening, diagnosis, prognosis, and monitoring treatment response. By understanding the strengths and limitations of specific tumour markers, clinicians can optimize their utility and integrate them into a comprehensive management plan for patients with gastrointestinal malignancies. Further research and advancements in tumour marker technologies hold the potential to enhance their accuracy and expand their clinical applications in the future.