Levels of CEA and Ca 19 - 9 in the sera and peritoneal cavity in patients with gastric and pancreatic cancers

Abstract

PURPOSE:Tumor markers are substances found in blood and other biological fluids if tumor is present in the body. They can be produced by tumor itself or can be results of cancer -body relation. They may be used in the follow-up of cancer patients to identify tumor recurrence. Pre-treatment levels have prognostic tool and could signalize persistence of minimal residual disease despite radical surgery. METHODS:We operated on 52 patients with upper GI malignancy (32 with gastric cancer and 20 with pancreatic cancer). Blood samples were taken before surgery and peritoneal samples immediately after laparotomy before any manipulation with tumor. All samples were examined by standard biochemical technique and the level was compared with a stage of the disease. RESULTS:Patients suffering from gastric carcinoma of stage I and II had higher level of both markers in sera then in the peritoneal cavity, however most of them were within physiological range. Patients in stage III and IV had average marker levels in the peritoneal cavity higher than in sera. Number of positive findings was increasing according to the stage of the disease. The peritoneal levels of both markers varied extremely in higher stages. In patients suffering from pancreatic carcinoma the CEA levels both in sera and peritoneal cavity were parallel but peritoneal levels were slightly higher in stages III and IV. Ca 19 -9 was more sensitive for pancreatic cancer.The percentage of positive findings was higher in sera but the level of Ca 19 -9 was higher in the peritoneal cavity. The number of positive findings again correlated with the stage of the disease. CONCLUSIONS: Levels of tumor markers in sera could signalize inoperability of tumor (Ca 19 -9 in cases of pancreatic carcinoma); peritoneal levels could predict R1 resection especially in gastric cancer patients and risk of early peritoneal recurrence of the disease.Difference between the levels in the peritoneum and sera may signalize the route of dissemination (hematogenous and intraperitoneal).

Dendritic Cell/Cytokine-Induced Killer Cell Immunotherapy Combined with S-1 in Patients with Advanced Pancreatic Cancer: A Prospective Study

“…Among these, the most common and best-identified marker for pancreatic cancer is CA19-9 (27). Previous studies also showed that serum CA125 and CEA are important tumor biomarkers for the early diagnosis of pancreatic cancer (28,29). In this study, our results showed that CEA and CA-199 levels decreased in the greatest percentage of patients in the DC-CIK plus S1 group, and was associated with better outcome compared with other groups.…”

Classic Tumor Markers in Gastric Cancer. Current Standards and Limitations

“…The detection of high levels in the peritoneal fluid can mean that the case is inoperable or that there is a risk of tumor residue after resection (R1). This is very useful in primary assessment or at the end of neoadjuvant chemotherapy, the risk of an early relapse at peritoneal level being high in this category of patients [ 41 ].…”

Diagnostic value of circulating microRNAs for gastric cancer in Asian populations: a meta-analysis

“…Although chromo endoscopy and random biopsies are considered to be reliable and credible methods for diagnosis, their applications are limited due to the examination's cost and invasive and unpleasant nature and random biopsy's potential for sampling errors [7]. On the other hand, CEA, the widely used tumor biomarkers for GC, has the limitation of low accuracy, with normal levels in nearly all patients with earlystage GC and in nearly 70 % of advanced-stage patients [8]. Meanwhile, other conventional biomarkers, such as pepsinogen (PG), carbohydrate antibody 12-5 (CA 12-5), carbohydrate antibody 72-4 (CA 72-4), and carbohydrate antigen , also display insufficient sensitivity and specificity for screening early-stage GC [4,7].…”