Duan XX, Yu X, Zhou L. Timeliness of postoperative serum carcinoembryonic antigen monitoring for predicting recurrence after gastric cancer surgery. World J Gastrointest Surg 2026; 18(1): 114309 [DOI: 10.4240/wjgs.v18.i1.114309]
Corresponding Author of This Article
Li Zhou, MBBS, Chief Nurse, General Surgery Center, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital, No. 48 Taling South Road, Xunyang District, Jiujiang 332000, Jiangxi Province, China. liwei880904oioi@163.com
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Gastroenterology & Hepatology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Jan 28, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Duan XX, Yu X, Zhou L. Timeliness of postoperative serum carcinoembryonic antigen monitoring for predicting recurrence after gastric cancer surgery. World J Gastrointest Surg 2026; 18(1): 114309 [DOI: 10.4240/wjgs.v18.i1.114309]
World J Gastrointest Surg. Jan 27, 2026; 18(1): 114309 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114309
Timeliness of postoperative serum carcinoembryonic antigen monitoring for predicting recurrence after gastric cancer surgery
Xin-Xing Duan, Xiong Yu, Li Zhou
Xin-Xing Duan, Xiong Yu, Li Zhou, General Surgery Center, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital, Jiujiang 332000, Jiangxi Province, China
Author contributions: Duan XX designed the study, collected and analyzed the data, and drafted the initial manuscript; Yu X participated in data verification and provided critical input during manuscript refinement; Zhou L supervised the entire research process, formulated key research directions, revised the manuscript for intellectual content, coordinated peer review responses, and ensured the integrity of the work; all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital (Approval No. JJSDYRMYY-YXLL-2024-239).
Informed consent statement: All participants provided written informed consent before enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Zhou, MBBS, Chief Nurse, General Surgery Center, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital, No. 48 Taling South Road, Xunyang District, Jiujiang 332000, Jiangxi Province, China. liwei880904oioi@163.com
Received: September 16, 2025 Revised: October 22, 2025 Accepted: November 19, 2025 Published online: January 27, 2026 Processing time: 127 Days and 19.2 Hours
Abstract
BACKGROUND
Postoperative recurrence remains a major challenge in gastric cancer management. Monitoring serum biomarkers such as carcinoembryonic antigen (CEA) may enable earlier detection of recurrence and improve patient outcomes.
AIM
To evaluate postoperative serum CEA expression and its efficacy in predicting gastric cancer recurrence.
METHODS
This retrospective study analyzed clinical data from 120 patients with primary gastric cancer treated between January 2022 and January 2023. Patients were categorized into recurrence and non-recurrence groups. Serum levels of CEA, alpha-fetoprotein (AFP), and carbohydrate antigen 19-9 (CA19-9) were measured at one week, three months, and six months postoperatively. Logistic regression identified independent risk factors for recurrence, Pearson correlation assessed the association with recurrence timing, and receiver operating characteristic (ROC) curves evaluated the predictive performance of combined CEA and AFP levels.
RESULTS
During 24 months of follow-up, 39 patients (32.50%) experienced recurrence. No significant baseline differences were observed between groups (P > 0.05). CEA, AFP, and CA19-9 levels at one week were comparable between groups (P > 0.05), whereas levels at three and six months were significantly higher in the recurrence group (P < 0.05). Logistic regression identified postoperative CEA and AFP as independent risk factors for recurrence (P < 0.05). Pearson correlation showed a negative association between CEA and AFP levels and recurrence interval (P < 0.05). ROC curve analysis demonstrated that combined CEA and AFP yielded an area under the curve of 0.826, with specificity of 94.36% and sensitivity of 90.50%, outperforming either marker alone (P < 0.05).
CONCLUSION
Dynamic postoperative monitoring of serum CEA and AFP enables early prediction and detection of gastric cancer recurrence.
Core Tip: Dynamic monitoring of carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels at three and six months after gastrectomy is crucial for postoperative management of gastric cancer. Elevated levels of these markers serve as independent risk factors for recurrence. Combined assessment of CEA and AFP enhances predictive accuracy, yielding an area under the curve of 0.826, and offers superior sensitivity and specificity compared with either marker alone. This combined approach facilitates earlier detection and timely intervention for recurrent gastric cancer.
