Combined evaluation of preoperative serum sialyl-Tn antigen and carcinoembryonic antigen levels is prognostic for gastric cancer patients

Abstract

We have found that elevation of preoperative serum sialyl-Tn antigen (STN) levels is associated with a poor prognosis for gastric cancer patients, and these high levels remain in the advanced stage of the disease. We have now examined findings with the combined assay of STN and carcinoembryonic antigen (CEA) levels with regard to prediction of the prognosis of gastric cancer patients. Serum CEA levels and STN levels were determined preoperatively in 349 Japanese patients with gastric cancer. The patients were divided into four groups: (A) the CEA (-) STN (-) group (CEA < or = 5 ng ml-1, STN < or = 45 U ml-1, n = 286); (B) the CEA (-) STN (+) group (CEA < or = 5 ng ml-1, STN > 45 U ml-1, n = 31); (C) the CEA (+) STN (-) group (CEA > 5 ng ml-1, STN < or = 45 U ml-1, n = 17); and (D) the CEA (+) STN (+) group (CEA > 5 ng ml-1, STN > 45 U ml-1, n = 15). Clinicopathological features and the prognosis of these groups were examined. The distribution of two markers showed no significant correlation. The patients in the CEA (+) STN (+) group (group D) had more advanced disease than the patients in CEA (-) STN (-) group (group A); tumour size was larger, serosal invasion was prominent, lymphatic and vascular involvement was frequent and the tumour was more infiltrative. Lymph node metastasis and hepatic metastasis were more common. Total gastrectomy was usually performed, and the non-curative rate was higher. The 5-year survival of patients in the CEA (+) STN (+) (group D) was 14.5 +/- 9.5%, that is lower than that of patients in any other group [CEA (+) STN (-) (group C) 44.1 +/- 12.7% (P < 0.05); CEA (-) STN (+) (group B) 60.1 +/- 9.5% (P > 0.05); CEA (-) STN (-) (group A) 77.6 +/- 9.5% (P < 0.05)]. This combined assay of these markers will aid in estimating the prognosis and selecting appropriate drugs and care for gastric cancer patients.

Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association

“…Four discussion points were evaluated for CEA, CA19-9, and CA72-4 from selected articles as follows: (1) positive rates, (2) clinicopathological significance, (3) prognostic impact, and (4) clinical impact during follow-up after surgery and/or during chemotherapy. Finally, we selected 10 other publications that focused only on AFP [51][52][53][54], CA125 [3,[55][56][57], and STN [58,59] (Fig. 1).…”

“…Takahashi et al [4,58] evaluated the clinical significance of the serum STN level as a tumor marker in 350 patients with gastric cancer. Histologically, the tumors in the high STN group were deeply penetrating and the rates of lymphatic involvement, vascular involvement, and lymph node and hepatic metastases were higher.…”

Correlation between sialyl Tn antigen and lymphatic metastasis in patients with Borrmann type IV gastric carcinoma

“…The avidin-biotin-peroxidase complex method was used for PCNA staining, as described elsewhere (Kakeji et al, 1994). The primary antibody was PCIO (Dako, Carpinteria, CA, USA).…”

“…The NOR staining solution was prepared according to the description of Ploton et al (1982 (Figure 1 (Figure 2b). Quantitative differences in cell-surface sialic acid (total cellsurface sialic acid levels) and qualitative changes in sialylated oligosaccharides (presence or absence of a particular oligosaccharide structure or individual glycoconjugates) are commonly associated with metastasis (Yogeeswaran and Salk, 1981;Altevogt et al, 1983;Passaniti and Hart, 1988 (Kakeji et al, 1991(Kakeji et al, , 1994 (Itzkowitz et al, 1990) …”

“…Sialyl Tn antigen (STn) is one of these abnormal 0-linked glycoproteins. The Tn antigen is a precursor of the ThomsenFreidenreich antigen, the T antigen, and STn is a sialic acid-bound Tn antigen (Hakomori and Kannagi, 1983;Springer, 1984;Kjeldsen et al, 1988 (Takahashi et al, 1993(Takahashi et al, , 1994. Immunobistochemically, Ma et al (1993) Imamura et al (1989).…”