I. Takahashi et al., COMBINED EVALUATION OF PREOPERATIVE SERUM SIALYL-TN ANTIGEN AND CARCINOEMBRYONIC ANTIGEN LEVELS IS PROGNOSTIC FOR GASTRIC-CANCER PATIENTS, British Journal of Cancer, 69(1), 1994, pp. 163-166
We have found that elevation of preoperative serum sialyl-Tn antigen (
STN) levels is associated with a poor prognosis for gastric cancer pat
ients, and these high levels remain in the advanced stage of the disea
se. We have now examined findings with the combined assay of STN and c
arcinoembryonic 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 c
ancer. The patients were divided into four groups: (A) the CEA (-) STN
(-) group (CEA less than or equal to 5 ng ml(-1), STN less than or eq
ual to 45 U ml(-1), n = 286); (B) the CEA (-) STN (+) group (CEA less
than or equal to 5 ng ml(-1), STN> 45 U ml(-1); n = 31); (C) the CEA (
+) STN (-) group (CEA> 5 ng ml(-1), STN less than or equal to 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 prom
inent, lymphatic and vascular involvement was frequent and the tumour
was more infiltrative. Lymph node metastasis and hepatic metastasis we
re more common. Total gastrectomy was usually performed, and the non-c
urative 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 pati
ents 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 mark
ers will aid in estimating the prognosis and selecting appropriate dru
gs and care for gastric cancer patients.