Significance of serum and tissue carcinoembryonic antigen for the prognosis of gastric carcinoma patients

Background and Objectives: Carcinoembryonic antigen (CEA) has been widely a ccepted as a tumor marker useful in the diagnosis and management of colorec tal carcinoma. When CEA levels are positive in patients with gastric carcin oma, they could be useful prognostic indicators. The value of CEA as a tumo r marker for gastric carcinoma, however, remains a matter of controversy. T he purpose of this study was to determine whether preoperative serum CEA va lue and tissue CEA staining are useful prognostic indicators for gastric ca rcinoma. Methods: We measured preoperative serum CEA levels by radioimmunoassay and stained tissue CEA production by tumor cells from gastric carcinomas using immunohistochemical staining in patients with gastric carcinoma. Results: The patients with preoperative serum CEA levels >10.0 ng/mL had a more prominent serosal invasion, much more lymph node involvement, more adv anced stage and more poorly differentiated than did the patients with preop erative serum CEA levels <5.0 ng/mL. The survival rate of patients with ser um CEA levels >10.0 ng/mL was poorer than those of patients with serum CEA levels between 5.0 and 10.0 ng/mL, and those of patients with serum CEA lev els <5.0 ng/mL (P < 0.05). The preoperative serum CEA levels and tumor CEA- positivity were correlated (P < 0.05). In patients with lymph node metastas es, the CEA-positivity (78.0%) was higher than in patients without lymph no de metastasis (63.2%) (P < 0.05). A correlation was also found between the depth of tumor invasion and tissue CEA-positivity (P < 0.001). The postoper ative survival rate was significantly better in the CEA-negative staining g roup (78.0%) than in the CEA-positive staining group (60.0%). Conclusions: These data suggest that preoperative serum CEA levels and stai ning for CEA in gastric carcinoma tissue sections may have a predictive val ue in determining prognostic information for patients with resectable gastr ic carcinoma. J. Surg. Oncol. 2000;74:185-192. (C) 2000 Wiley-Liss, Inc.