N. Duraker et An. Celik, The prognostic significance of preoperative sevum CA 19-9 in patients withresectable gastric carcinoma: Comparison with CEA, J SURG ONC, 76(4), 2001, pp. 266-271
Background and Objectives: In this study, the prognostic value of preoperat
ive serum levels of tumor markers CA 19-9 and carcinoembryonic antigen (CEA
) in gastric carcinoma which has been a controversial matter was investigat
ed.
Methods: Preoperative serum CA 19-9 (cut-off value 37 U/ml) and CEA (cut-of
f value 5 ng/ml) levels were measured in 168 patients with resectable gastr
ic carcinoma. The correlation between tumor marker levels and clinicopathol
ogical features and overall survival was studied.
Results: CA 19-9 and CEA positivity rates were 31.5 and 17.8% respectively.
In CA 19-9 positive patients, the ratio of males, tumors exceeding subsero
sa and advanced stage tumors (stages III and IV) was significantly higher (
P = 0.052, P = 0.0005 and P = 0.029, respectively). A weak correlation was
found with CA 19-9 positivity and tumor location, however, no correlation e
xisted between CA 19-9 positivity and age, tumor size, histologic type, lym
ph node, hepatic and peritoneal metastasis. The proportion of tumors extend
ing beyond subserosa and with Lymph node metastasis was significantly highe
r in CEA positive patients (P = 0.811 and P = 0.045, respectively). No corr
elation was found between CEA positivity and gender, age, tumor location, t
umor size, and hepatic and peritoneal metastasis: however, a weak correlati
on existed between CEA positivity and histologic type and tumor stage. Over
all survival was significantly poorer in CA. 19-9 and CEA positive patients
(log-rank test, P = 0.014, P = 0.003, respectively). However, the Cos prop
ortional hazards regression analysis did not show independent prognostic va
lue for both tumor markers.
Conclusions: In resectable gastric carcinoma, preoperative serum CA 19-9 an
d CEA levels ma indicate stage of the disease, but neither has an independe
nt prognostic value. (C) 2001 Wiley-Liss, Inc.