Perioperative Serum Carcinoembryonic Antigen Levels Predict Recurrence and Survival of Patients with Pathological T2-4 Gastric Cancer Treated with Curative Gastrectomy

Abstract

Background/Aims: Do serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels serve as prognostic indicators in patients with gastric cancer (GC)? This is a question that has long been disputed. The aim of this study was to evaluate the significance of perioperative serum levels of CEA and CA19-9 for predicting the recurrence and long-term survival after patients with pT2-4 GC undergo curative gastrectomy. Methods: This study included 251 patients with radically resected pT2-4 GC without preoperative treatment. Associations between the preoperative and postoperative serum levels of CEA or CA19-9 and postoperative long-term outcomes and recurrence patterns were evaluated. Results: Preoperative CEA >5.0 ng/mL was an independent prognostic factor of overall survival. Elevation of both preoperative CEA and CA19-9 levels showed no synergistic adverse effects on prognosis. Preoperative levels of these markers achieved superior predictive performance compared with the postoperative values. Adverse prognosis is significantly associated with persistent elevation of CEA levels before and after gastrectomy. Elevation of CEA levels, particularly at postoperative measurement, was significantly associated with hematogenous recurrence. Conclusion: Determination of perioperative CEA levels facilitated predictions of recurrence patterns and prognosis among patients with pT2-4 GC who underwent curative gastrectomy.

Integrated multigene expression panel to prognosticate patients with gastric cancer

“…However, these are invasive procedures with a significant cost for patients. However, noninvasive serum tumor markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 are widely used in clinical practice, but have limited sensitivity and specificity, limiting their utility in decision making and management of patients with gastric cancer [ 6 – 8 ]. With the development of genomics, proteomics, and metabolomics, an increasing number of biomarkers have been identified and studied [ 9 ].…”

The significance of preoperative serum carcinoembryonic antigen levels in the prediction of lymph node metastasis and prognosis in locally advanced gastric cancer: a retrospective analysis

“…In previous studies, it has been reported that CEA in serum is an independent prognostic factor, while CEA in tumour tissues is not [15]. Uda et al [16] performed a retrospective study with a median follow-up of 39.6 months in 251 T2-4 GC patients. The 5-year survival rate was significantly lower in the preoperative CEA- positive group than in the CEA-negative group, and this difference was further confirmed in the multivariate analysis.…”

“…However, because early GC and LAGC are significantly different in terms of lymph node statue and survival, the predictive value of CEA for determining LNM may be low if the two stages are not separated. In addition, whether preoperative CEA levels can predict the survival of patients with GC is still controversial [11,[14][15][16][17][18][19][20].…”

Cancer Antigen 72-4 for the Monitoring of Advanced Tumors of the Gastrointestinal Tract, Lung, Breast and Ovaries

“…The glycoprotein, with a half-life of approximately 7 days, was found to be expressed in gastrointestinal and mucosal tissue during fetal development but only minimally expressed in adult tissue (15,16). Further studies showed that it was also overexpressed in adenocarcinomas of varying origin including gastric, hepatic, lung, pancreatic, ovarian and prostate (17)(18)(19)(20)(21)(22)(23)(24). In colon cancer, the specificity and sensitivity of CEA has been shown to vary with advancing tumor stage, with specificity ranging between 37% and 86% in advanced disease, providing a useful means of monitoring disease (25)(26)(27).…”