Objective To evaluate the clinical value of abnormal prothrombin (PIVKA-Ⅱ) combined with CEA, CA199 and CA72-4 on the diagnosis, treatment, recurrence and metastasis of patients with gastric cancer.

Methods Serum PIVKA-Ⅱ, CEA, CA72-4, CA199 levels in 123 gastric cancer patients, 80 healthy controls and 30 benign gastric diseases patients were performed by chemiluminescent immunoassay(CLIA), electrochemiluminescence immunoassay (ECLIA), respectively. And random 20 patients with gastric cancer were followed up.

Results The level of PIVKA-Ⅱ was significantly higher in gastric cancer group than those in benign gastric disease group and healthy control group (all P < 0.001). ROC analysis showed the cut-off value to discriminate cancer from control was established at 32.14U/L for PIVKA-Ⅱ (sensitivity (39.84%), specificity (95%)). The sensitivity of PIVKA-Ⅱ was not significantly higher than CEA, CA199 or CA72-4, while the specificity was slightly lower. With the rising of gastric carcinoma stage, the levels of PIVKA-Ⅱ as well as the positive rate were increased (all P < 0.05). Elevated levels of PIVKA-Ⅱ were found in the recurrent or metastasis disease patients, and the levels were decreased in 20 patients who were sensitive to therapy. The sensitivity and effectiveness of the group of four tumor markers were the highest in all combination groups.

Conclusion There is specifically clinical application value of PIVKA-Ⅱ, CEA, CA199 and CA72-4 in the diagnosis, curative effect and prognosis monitoring of gastric cancer.