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Plasma DNA good indicator of recurrent esophageal carcinoma
Compared with carcinoembryonic antigen, plasma DNA was superior in the detection of unresectable esophageal cancer.
Researchers from the Keck School of Medicine and Response Genetics Inc., both in Los Angeles, compared the use of plasma DNA and carcinoembryonic antigen in the detection of recurrent esophageal cancer.
Using polymerase chain reaction, the researchers measured plasma DNA postoperatively in 45 patients with esophageal cancer and 44 asymptomatic control patients. Carcinoembryonic antigen was measured in 31 patients. Control patients with levels of 19 ng/mL were used to define normal.
Patients with local disease with resection (n=39) and disseminated disease at operation (n=6) were identified.
Compared with carcinoembryonic antigen, plasma DNA was more sensitive in the detection of unresectable esophageal cancer (40% vs. 100%). However, plasma DNA had a lower specificity (22% vs. 89%).
Plasma DNA and serum carcinoembryonic antigen were similar for positive predictive value (19% and 40%) and negative predictive value (100% and 89%).
In the detection of recurrent esophageal cancer, plasma DNA was also more sensitive than carcinoembryonic antigen (100% vs. 33%). Prior to clinical evidence of recurrence, plasma DNA rose in 67% vs. 17% for carcinoembryonic antigen.
J Am Coll Surg. 2008;207:30-35.