Huang ZB, Zhou X, Xu J, Du YP, Zhu W, Wang J, Shu YQ, Liu P. Prognostic value of preoperative serum tumor markers in gastric cancer. World J Clin Oncol 2014; 5(2): 170-176 [PMID: 24829865 DOI: 10.5306/wjco.v5.i2.170]
Corresponding Author of This Article
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
Research Domain of This Article
Oncology
Article-Type of This Article
Research Report
Open-Access Policy of This Article
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Table 2 Correlation between tumor makers and major clinicopathologic characteristics of 363 patients with gastric cancer n (%)
Patient characteristics
Cases
CEA (+)
P
CA19-9 (+)
P
CA50 (+)
P
Age (yr)
< 0.001
0.213
0.134
< 60
169 (46.6)
26 (15.4)
36 (21.7)
40 (28.4)
≥ 60
194 (53.4)
61 (31.4)
31 (16.5)
31 (20.8)
Gender
0.022
0.800
0.375
Male
266 (73.3)
72 (27.1)
48 (18.6)
48 (23.1)
Female
97 (26.7)
15 (15.5)
19 (19.8)
23 (28.0)
Tumor size (cm)
0.007
0.042
0.051
< 6
243 (66.9)
48 (19.8)
38 (16.0)
40 (20.9)
≥ 6
120 (33.1)
39 (32.5)
29 (25.0)
31 (31.3)
Tumor location
0.463
0.737
0.662
Cardia or fundus
117 (33.1)
33 (28.2)
21 (18.6)
20 (22.0)
Corpus or angulus
131 (37.1)
31 (23.7)
22 (17.2)
26 (25.2)
Antrum
103 (29.2)
21 (20.4)
22 (21.8)
24 (28.2)
Whole stomach
2 (0.6)
1 (50.0)
0 (0.0)
0 (0.0)
Differentiation
0.65
0.671
0.701
Well/moderate
61 (16.8)
16 (26.2)
10 (16.9)
10 (22.2)
Poorly
302 (83.2)
71 (23.5)
57 (19.3)
61 (24.9)
T category
0.018
0.058
0.308
pT1-pT2
48 (13.2)
5 (10.4)
4 (8.7)
7 (17.9)
pT3-pT4
315 (86.8)
82 (26.0)
63 (20.5)
64 (25.5)
N category
0.109
< 0.001
0.001
pN0
61 (16.8)
14 (23.0)
10 (16.7)
10 (21.3)
pN1
73 (20.1)
10 (13.7)
5 (6.9)
10 (16.9)
pN2
100 (27.5)
29 (29.0)
12 (12.5)
10 (13.5)
pN3
129 (35.5)
34 (26.4)
40 (31.7)
41 (37.3)
Vascular/nerves invasion
0.997
0.950
0.763
Negative
171 (47.1)
41 (24.0)
31 (18.8)
30 (23.6)
Positive
192 (52.9)
46 (24.0)
36 (19.0)
41 (25.2)
AJCC stage
0.347
0.084
0.187
I
2 (0.6)
0 (0.0)
0 (0.0)
0 (0.0)
II
97 (26.7)
19 (19.6)
11 (11.7)
13 (17.6)
III
264 (72.7)
68 (25.8)
56 (21.7)
58 (27.1)
Table 3 Univariate model for disease-free survival and overall survival by log-rank test
Tumor markers
DFS (P)
OS (P)
CEA (+)
0.197
0.023
CA19-9 (+)
0.236
0.009
CA50 (+)
0.335
0.004
CEA (+) and CA19-9 (+)
0.236
0.026
CA50 (+) and CEA (+)
0.236
0.100
CA19-9 (+) and CA50 (+)
0.236
0.021
CEA (+) and CA19-9 (+) and CA50 (+)
0.397
0.751
CEA (+) or CA19-9 (+) or CA50 (+)
0.302
0.002
Table 4 Univariate model for disease-free survival and overall survival by log-rank test when considering the adjuvant chemotherapy
Tumor
DFS (P)
OS (P)
markers
Adjuvant chemotherapy
Non-adjuvant chemotherapy
Adjuvant chemotherapy
Non-adjuvant chemotherapy
CEA (+)
0.878
0.116
0.297
0.017
CA19-9 (+)
0.961
0.116
0.179
< 0.001
CA50 (+)
0.828
0.182
0.069
0.001
CEA (+) and CA19-9 (+)
0.961
0.116
0.304
0.004
CA50 (+) and CEA (+)
0.991
0.132
0.383
0.065
CA19-9 (+) and CA50 (+)
0.991
0.132
0.303
< 0.001
CEA (+) and CA19-9 (+) and CA50 (+)
0.991
0.132
0.867
0.298
CEA (+) or CA19-9 (+) or CA50 (+)
0.742
0.196
0.107
< 0.001
Table 5 Independent prognostic factors for predicting disease-free survival and overall survival by multivariate analysis using Cox model
Factors
DFS
OS
HR
95%CI
P
HR
95%CI
P
Age
1.028
0.825-1.770
0.331
0.932
0.667-1.303
0.682
Gender
1.072
0.634-1.814
0.795
0.791
0.543-1.151
0.220
Tumor size
1.718
1.159-2.546
0.007
1.998
1.433-2.785
< 0.001
Differentiation
1.398
0.685-2.853
0.357
0.714
0.398-1.281
0.258
T category
0.796
0.213-2.978
0.734
6.042
2.190-16.668
0.001
N category
1.014
0.836-1.231
0.884
1.734
1.429-2.014
< 0.001
Vascular/nerves invasion
0.930
0.606-1.426
0.739
1.515
1.045-2.195
0.028
Adjuvant chemotherapy
0.931
0.614-1.411
0.736
0.618
0.425-0.898
0.012
CEA
3.045
0.401-23.157
0.282
0.902
0.618-1.316
0.592
CA19-9
0.392
0.045-3.384
0.394
0.836
0.449-1.556
0.571
CA50
1.058
0.546-2.050
0.868
1.470
0.842-2.569
0.176
Table 6 Multivariate analysis of overall survival of patients without chemotherapy
Factors
OS
HR
95%CI
P
Age
1.525
0.765-3.041
0.230
Gender
1.229
0.559-2.701
0.608
Tumor size
4.758
2.339-9.678
< 0.001
Differentiation
0.784
0.259-2.379
0.668
T category
4.566
0.570-36.569
0.153
N category
2.096
1.506-2.916
< 0.001
Vascular/nerves invasion
2.861
1.247-6.566
0.013
CEA
1.329
0.670-2.637
0.415
CA19-9
5.077
1.203-21.427
0.027
CA50
0.671
0.183-2.463
0.547
Citation: Huang ZB, Zhou X, Xu J, Du YP, Zhu W, Wang J, Shu YQ, Liu P. Prognostic value of preoperative serum tumor markers in gastric cancer. World J Clin Oncol 2014; 5(2): 170-176