Objective  To analyze clinical significance of five serum tumor markers in patients with coal-burning arsenic poisoning and to provide evidences for early detection of cancer among arsenism patients.

  Methods  In Yuzhang region of Guizhou province – an endemic area with coal-burning arsenic poisoning, we recruited 186 arsenism patients and divided them into a mild, moderate, and severe arsenism group (n = 49, 66, and 71); we also selected 85 non-arsenism residents in a non endemic region but with similar living habits to those of the arsenism patients as the controls. Fasting peripheral venous blood samples were collected among all the participants under informed consent for detections of serum carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), cytokeratin 19 soluble fragment (CYFRA21-1), carbohydrate antigen 72-4 (CA72-4), and carbohydrate antigen 199 (CA19-9) with electrochemiluminescence immunoassay.

  Results  Compared with the those in the control group, AFP, CYFRA21-1, CA72-4, and CEA increased significantly in all arsenism groups (P < 0.05 for all), except for CEA in the mild arsenism group. In comparison with those in the mild arsenism group, serum CEA and CYFRA21-1 increased significantly in severe arsenism group (both P < 0.05). There was no significant difference in serum CA19-9 among the various groups (P > 0.05). The positive rates of CEA, AFP, CYFRA21-1, CA72-4, and CA19-9 were 0%, 1.59%, 0%, 3.17%, and 1.59% in the controls and those were 16.13%, 2.69%, 24.73%, 29.57%, and 9.14% in all the arsenism patients, respectively. The positive rates of serum CEA, CYFRA21-1, and CA72-4 were significantly higher in arsenism patients than those in the controls (P < 0.05 for all).

  Conclusion  Serum CEA, CYFRA21-1, and CA72-4 may be of important significance for early detection of lung, liver and stomach tumors among residents with arsenism.