Research Report
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Clin Oncol. May 10, 2014; 5(2): 170-176
Published online May 10, 2014. doi: 10.5306/wjco.v5.i2.170
Prognostic value of preoperative serum tumor markers in gastric cancer
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Huang ZB and Zhou X contributed equally to this work; Zhu W and Liu P designed research; Huang ZB, Zhou X, Xu J, Du YP, Zhu W, Wang J, Shu YQ and Liu P performed research; Huang ZB and Zhou X analyzed data; Huang ZB and Zhou X wrote the paper.
Correspondence to: Dr. Ping Liu, Professor, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. belliwether@163.com
Telephone: +86-25-83718836 Fax: +86-25-83780826
Received: November 3, 2013
Revised: November 30, 2013
Accepted: January 15, 2014
Published online: May 10, 2014
Processing time: 189 Days and 18.5 Hours
Abstract

AIM: To evaluate the prognostic value of preoperative carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, and CA50 in patients undergoing D2 resection.

METHODS: We evaluated 363 patients with gastric cancer who underwent gastrectomy at our hospital from January 2006 to December 2009. Blood samples were obtained from each patient within 1 wk before surgery. The cut-off values for serum CEA, CA19-9, and CA50 were 5 ng/mL, 37 U/mL, and 20 U/mL, respectively. The correlation between preoperative tumor marker levels and prognosis was studied by means of univariate and multivariate analyses.

RESULTS: The preoperative serum positive rates of CEA, CA19-9 and CA50 were 24.0%, 18.9% and 24.5%, respectively. The positivity rate of serum CEA was significantly correlated with age (P < 0.001), sex (P = 0.022), tumor size (P = 0.007) and depth of invasion (P = 0.018); CA19-9 with tumor size (P = 0.042) and lymph node metastasis (P < 0.001); and CA50 only with lymph node metastasis (P = 0.001). In multivariate analysis, tumor size, T category, N category, vascular or neural invasion, and adjuvant chemotherapy were independent prognostic factors for overall survival. CA19-9 had an independent prognostic significance in patients without adjuvant chemotherapy (P = 0.027).

CONCLUSION: Preoperative serum CEA, CA19-9 and CA50 are prognostic in patients with gastric cancer. Only CA19-9 is an independent prognostic factor after surgery without adjuvant chemotherapy.

Keywords: Gastric cancer; Carcinoembryonic antigen; Cancer antigen 19-9; Cancer antigen 50; Prognosis

Core tip: Recent researches have investigated the prognostic value of tumor markers in gastric cancer. The results were not conclusive and consistent. Most researchers did not account for some confounding factors, especially the use of adjuvant chemotherapy, so we investigated the prognostic value of carcinoembryonic antigen, carbohydrate antigen (CA)19-9 and CA50 in Chinese gastric cancer patients when considering the use of adjuvant chemotherapy. CA19-9 is an independent prognostic factor for gastric cancer patients after surgery without adjuvant chemotherapy.