CA 72.4

Cancer

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Tumor marker.

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CA 72.4 Test Information Guide

Why is it done?
- CA 72.4 is a tumor marker blood test that measures levels of carbohydrate antigen 72.4, a glycoprotein produced by certain malignant cells, primarily associated with gastrointestinal and ovarian malignancies
- Monitoring patients with gastric cancer, colorectal cancer, ovarian cancer, and pancreatic cancer for disease progression or recurrence
- Assessing treatment response in cancer patients undergoing chemotherapy or surgical intervention
- Performed during initial cancer diagnosis workup, at regular intervals during treatment follow-up, and as part of surveillance protocols for cancer recurrence
- Evaluating patients with benign gastrointestinal conditions that may also elevate CA 72.4 levels, such as gastritis or ulcers
Normal Range
- Reference Range: 0-6.9 U/mL (Units per milliliter), though some laboratories may use slightly different cutoff values (typically 0-4 or 0-6.9 U/mL)
- Normal Result: Values within or below the laboratory's upper reference limit are considered negative or normal, suggesting absence of significant malignancy
- Elevated Result: Values above 6.9 U/mL are considered elevated and may indicate presence of malignancy, though benign conditions can also elevate levels
- Borderline Values: Results between 5-10 U/mL may warrant repeat testing and clinical correlation, as they fall in a gray zone requiring careful interpretation
- Units of Measurement: U/mL (international units per milliliter of blood serum)
Interpretation
- Mildly Elevated (7-20 U/mL): May indicate early-stage malignancy, benign gastrointestinal conditions (gastritis, peptic ulcers, inflammatory bowel disease), or post-surgical changes; requires correlation with clinical presentation and imaging studies
- Moderately Elevated (20-100 U/mL): Suggests probable malignancy, particularly gastric or ovarian cancer; warrants urgent diagnostic investigation including imaging and endoscopy as clinically appropriate
- Markedly Elevated (>100 U/mL): Highly suggestive of advanced malignancy with significant tumor burden; indicates need for aggressive diagnostic workup and treatment planning
- Declining Values During Treatment: Indicates positive treatment response and tumor regression; gradual normalization suggests effective therapy
- Rising Values During Remission: May indicate cancer recurrence before imaging findings appear; particularly useful for early detection of relapse
- Factors Affecting Interpretation: Tobacco use, alcohol consumption, liver disease, cirrhosis, and recent surgery may transiently elevate levels; smoking history is particularly important as it elevates CA 72.4; false positives can occur in up to 5% of healthy individuals
- Sensitivity and Specificity: Sensitivity approximately 50-75% for gastric cancer and 40-60% for ovarian cancer; not recommended as sole screening tool; most useful in monitoring known cancer patients
Associated Organs
- Primary Organs Involved:
  - Stomach (gastric cancer - primary indicator)
  - Colon and rectum (colorectal cancer)
  - Ovaries (ovarian cancer)
  - Pancreas (pancreatic cancer)
- Malignancies Associated with Elevated CA 72.4:
  - Gastric adenocarcinoma - most strongly associated; elevated in 50-75% of cases
  - Ovarian cancer - elevated in 40-60% of epithelial ovarian cancers
  - Colorectal cancer - elevated in 30-50% of cases
  - Pancreatic cancer - elevated in 30-40% of cases
  - Breast cancer - elevated in 20-30% of metastatic disease
  - Hepatocellular carcinoma and esophageal cancer - less common associations
- Benign Conditions Associated with Elevated CA 72.4:
  - Chronic gastritis and peptic ulcer disease
  - Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
  - Cirrhosis and chronic liver disease
  - Post-operative states and recent abdominal surgery
  - Active smoking and tobacco use
- Potential Complications of Associated Cancers:
  - Metastatic disease spread to liver, peritoneum, and distant organs
  - Bowel obstruction and perforation in gastrointestinal malignancies
  - Peritoneal carcinomatosis and ascites
  - Malnutrition and cachexia due to advanced malignancy
Follow-up Tests
- Imaging Studies:
  - CT (computed tomography) of abdomen and pelvis - standard staging and surveillance imaging
  - PET-CT (positron emission tomography with CT) - for detecting metastatic disease and assessing treatment response
  - MRI (magnetic resonance imaging) - particularly useful for ovarian and liver assessment
  - Ultrasound - initial screening tool for abdominal and pelvic abnormalities
  - Chest X-ray or chest CT - to exclude pulmonary metastases
- Endoscopic Procedures:
  - Upper endoscopy (EGD) - to visualize gastric tumors and obtain biopsy specimens
  - Colonoscopy - for colorectal cancer evaluation and surveillance
- Complementary Tumor Markers:
  - CEA (carcinoembryonic antigen) - complementary marker for colorectal and gastric cancers
  - CA 19.9 - for pancreatic and gastrointestinal cancers
  - CA 125 - for ovarian cancer assessment
  - HER2 testing - for therapeutic decision-making in gastric cancer
- Laboratory Tests:
  - Complete blood count (CBC) - assess for anemia and infections
  - Comprehensive metabolic panel (CMP) - evaluate liver and kidney function
  - Albumin and prealbumin levels - assess nutritional status in cancer patients
- Surveillance Protocol:
  - Repeat CA 72.4 testing every 1-3 months during active treatment and post-operative period
  - Every 3-6 months during first 2-3 years of remission, then annually for long-term surveillance
  - Rising trends warrant immediate radiologic investigation regardless of absolute value
Fasting Required?
- Fasting Requirement: NO - Fasting is not required for CA 72.4 testing
- Blood Collection:
  - Simple venipuncture (blood draw) requiring 5-7 mL of serum collected in standard blood collection tube
  - Can be performed at any time of day without time restrictions
- Patient Preparation:
  - No special dietary restrictions needed; normal diet and hydration are permitted
  - No requirement to avoid medications before testing unless specifically instructed by physician
  - Tobacco and alcohol use do not need to be discontinued before testing, though these substances may affect results
  - Inform phlebotomist of any ongoing chemotherapy or immunotherapy as timing relative to treatment may affect levels
  - Recent surgery (within past 4 weeks) should be noted as this can transiently elevate CA 72.4
- Timing Considerations:
  - For most accurate results, baseline testing should be done before initiation of cancer treatment when possible
  - Serial measurements are typically more informative than single isolated results; consistent timing of blood draws (morning preferred) enhances comparability

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