Prognostic Value of Carcinoembryonic Antigen, CA 19-9 and CA 72-4 in Gastric Carcinoma

Abstract

The prognostic value of preoperative serum levels of carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4 tumor markers was investigated in patients with gastric cancer. Eighty-two patients who underwent surgical resection of gastric cancer were entered in the study. Correlation analyses showed that CA 72-4 was more frequently positive in patients with advanced tumors (p = 0.04), lymph node invasion (p = 0.02), liver metastasis (p = 0.02) and peritoneal involvement (p = 0.03). CA 19-9 was more frequently positive in patients with advanced tumors (p = 0.01) and with serosal (p = 0.04), lymph node (p = 0.008) and peritoneal involvement (p = 0.02). CEA was more frequently positive in patients with liver metastasis (p = 0.03). Low 3-year cumulative survival was significantly associated with elevated serum levels of CA 72-4 (p = 0.004), CA 19-9 (p = 0.001) and CEA (p < 0.001). Age, tumor stage and CA 72-4 provided prognostic information in the multivariate analysis. Patients with elevated serum levels of CA 72-4 showed a 4.2 times higher risk of death than patients with low levels of the marker. Our results suggest that CA 72-4 has prognostic value in gastric cancer, and patients with a high preoperative serum level of CA 72-4 have a greater risk of death due to gastric cancer.

Preoperative hCGβ and CA 72‐4 are prognostic factors in gastric cancer

“…Several studies have demonstrated CEA to have independent prognostic value, 5,17-21 but in other studies no significant correlation with survival has been found. 6,7,13,22,23 CA 19-9 has also been shown to be an independent prognostic factor in some 5,19,22 but not in other studies. 6,7,13,21,23 Furthermore, CA 72-4 has been reported to be a stronger prognostic factor than CEA and CA 19-9 in gastric cancer 6 but in other studies CA 72-4 has lacked independent prognostic value.…”

“…6,7,13,22,23 CA 19-9 has also been shown to be an independent prognostic factor in some 5,19,22 but not in other studies. 6,7,13,21,23 Furthermore, CA 72-4 has been reported to be a stronger prognostic factor than CEA and CA 19-9 in gastric cancer 6 but in other studies CA 72-4 has lacked independent prognostic value. 5,7 Of the less-established tumour markers in gastric cancer, we have previously shown CA 242 to be an independent prognostic factor in colorectal cancer, 9 but to the best of our knowledge, the association between CA 242 and survival has not been reported in gastric cancer.…”

“…4 Few studies have been published that compare the prognostic value of CEA, CA 19-9 and CA 72-4 in gastric cancer, and the results have been conflicting. [5][6][7] We have previously demonstrated that another cancer-associated antigen, CA 242, has a sensitivity of 44% in gastric cancer 8 and that CA 242 is an independent prognostic factor in colorectal cancer. 9 However, to the best of our knowledge, no reports have been published on the prognostic significance of CA 242 in gastric cancer.…”

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

“…Although the positive rates for CEA, CA19-9, and CA72-4 were similar in detecting major tumors, CA72-4 had the highest positive rate in patients with nodal involvement or serosal invasion. Therefore, CA72-4 was the most useful marker for detecting advanced gastric cancer [34,39,42,43].…”

“…CEA was strongly associated with the T factor [29,30,33,37], [11] analyzed 68 patients with stage IV gastric cancer using multivariate analysis and concluded that an elevated CEA level was an independent risk factor for predicting liver metastases. A few reports have shown a significant association between elevated CEA and peritoneal metastases [18,34]. Although several reports showed that elevated CEA was significantly associated with differentiated tumor types [7,10,48,61], a few reports indicated an association with poorly differentiated types of tumors [29].…”