Serum macrophage migration‐inhibitory factor as a diagnostic and prognostic biomarker for gastric cancer

BACKGROUND: This study aimed to determine the potential diagnostic value of migration‐inhibitory factor (MIF) for gastric cancer in patients presenting with dyspepsia and its prognostic value for gastric cancer. METHODS: A cohort of 97 patients with histologically confirmed gastric adenocarcinoma and 222 patients with dyspepsia were recruited. Enzyme‐linked immunosorbent assay was used to measure serum MIF and carcinoembryonic antigen (CEA). RESULTS: The serum MIF concentrations were 6554.0 ± 204.1 pg/mL and 1453.7 ± 79.9 pg/mL, respectively, in gastric cancer patients and dyspeptic patients ( P < .001). Serum MIF levels increased with the advancing gastric pathologies ( P < .001). With the cutoff value of 3230 pg/mL, serum MIF had sensitivity, specificity, and accuracy of 83.5%, 92.3%, and 89.7%, respectively, in diagnosing gastric cancer, whereas the rates were 60.8%, 83.3%, and 76.5%, respectively, for serum CEA. Gastric cancer patients with serum MIF levels above 6600 pg/mL had a lower 5‐year survival rate than those with serum MIF level below that level ( P = .012). Higher serum CEA levels were also associated with poor survival. The prediction for 5‐year survival was even better ( P = .0001), using a combination of serum MIF and CEA. CONCLUSIONS: Serum MIF level, which correlates with gastric MIF expression, is a better molecular marker than CEA in diagnosing gastric cancer in patients presenting with dyspepsia. A combination of serum MIF and CEA predicts 5‐year survival better than the individual test. Cancer 2009. © 2009 American Cancer Society.