CEA, CA 19-9, and CA-50 in Monitoring Gastric Carcinoma

Abstract

This study was conducted to investigate the clinical utility of CEA, CA 19-9, and CA-50 in the diagnosis, monitoring, and prognosis of 62 gastric carcinoma patients having either adjuvant or palliative chemotherapy. Patients were divided in two groups: group A included patients treated on an adjuvant basis following a curative resection of gastric cancer, and group B included patients with residual disease post surgery or patients with inoperable tumor or generalized disease. Serum marker levels were measured in a prospective study just before the initiation of chemotherapy and before each course during chemotherapy. In group A, CEA was positive in 2/25 (8%) patients, CA 19-9 in 1/25 (4%), and CA-50 in 1/25 (4%). In group B the sensitivity of CEA was 48.6% (18/37 patients), of CA 19-9 64.9% (27/37 patients), and of CA-50 70.3% (26/37) patients. There was a significant correlation between the CA 19-9 and CA-50 levels in both groups. No correlation was found between the sensitivity or the absolute initial marker levels and the tumor's differentiation or extent of disease. In group A the only patient with initially elevated CA 19-9 and CA-50 values relapsed early while he was on adjuvant chemotherapy. It was also found that the rising final CA 19-9 and CA-50 values at the end of chemotherapy were correlated with an increased incidence of relapse, but not with the disease-free interval. In group B the initially low marker levels showed a trend to predict a favorable outcome of treatment. There was no statistically significant correlation between the marker titers before each course and response to chemotherapy. It is concluded that the comeasurement of CA 19-9 and CA-50, and to some degree of CEA, is justifiable for gastric cancer. The estimation of CA 19-9 and CA-50 may be useful for early detection of recurrence after curative surgery and adjuvant chemotherapy. In advanced or recurrent gastric cancer, the estimation of either CA 19-9 or CA-50 and CEA serum values may help in checking the prognosis, determining the efficacy of palliative treatment modalities, and recognizing recurrences.

Preoperative serum levels of ca 72-4, cea, ca 19-9, and Alpha-fetoprotein in patients with gastric cancer

“…The use of tumor markers has become a very attractive method for the detection and diagnosis of neoplastic diseases, as well as for the monitoring of their course after radical surgery or during chemotherapy 18,19 . One of the challenging problems in the diagnosis and postoperative follow-up of patients with gastric cancer is the low sensitivity of the tumor markers that are currently being used 8 .…”

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Liver, Bladder, Cervical, and Gastric Cancers

“…Monitoring response to therapy is an important tool that can spare nonresponding patients potentially serious adverse effects from chemotherapy and/or radiation therapy. Although the number of investigations is limited, results suggest that tumor markers correlate with responses as measured by conventional imaging techniques (507,508 ) and may be useful in the detection of recurrence.…”

Prognostic Factors that Affect the Survival of Gastric Cancer

“…In this study, the median number of examined lymph nodes was 19 (2-41). The twoyear survival rate was 86% for N0 patients, 73% for N1 (1-6 involved lymph nodes), 45% for N2 (7)(8)(9)(10)(11)(12)(13)(14)(15) patients, 35% for N3 (16 and over) patients, and 6% for Nx patients; in conclusion of univariate analysis the nodal stage had an effect on survival. The two-year survival rate for Nx patients is low as Nx patients are generally in Stage IV.…”