Dynamic monitoring of serum tumor markers in predicting recurrence after radical gastrectomy for gastric cancer

Table 6 Predictive value of dynamic change patterns of tumor markers for recurrence

Change pattern	Marker	AUC	95%CI	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	vs preoperative combined P value	vs four combined progressive elevation P value	Significance after correction
Progressive elevation	CEA	0.856	0.802-0.910	75	85.5	72.9	86.8	< 0.001	0.028	NS (α = 0.0125)
	CA19-9	0.842	0.786-0.898	72.1	84.1	70.6	85.2	< 0.001	0.021	Significant (α = 0.0125)
	CA72-4	0.838	0.781-0.895	69.1	86.9	73.4	84.3	< 0.001	0.019	Significant (α = 0.0125)
	CA125	0.831	0.773-0.889	67.6	85.5	71.9	83.2	< 0.001	0.015	Significant (α = 0.0125)
	Four combined	0.912	0.869-0.955	85.3	89	80.6	91.5	0.003	Reference	Reference
Recurrent elevation	CEA	0.801	0.740-0.862	73.5	78.6	64.1	85	< 0.001	< 0.001	-
	CA19-9	0.794	0.732-0.856	70.6	77.2	62.3	83.3	< 0.001	< 0.001	-
	CA72-4	0.787	0.724-0.850	67.6	79.3	63.9	82.1	< 0.001	< 0.001	-
	CA125	0.778	0.714-0.842	64.7	78.6	61.1	81	< 0.001	< 0.001	-
	Four combined	0.868	0.818-0.918	79.4	83.4	73	87.8	0.015	0.008	-

Bonferroni method was used to correct for multiple comparisons, with corrected significance level α = 0.0125 (0.05/4). Recurrent elevation pattern was not analyzed with multiple comparison correction. AUC: Area under the curve; CI: Confidence interval; NS: Not significant; PPV: Positive predictive value; NPV: Negative predictive value; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; CA72-4: Carbohydrate antigen 72-4; CA125: Carbohydrate antigen 125.