Predictive value of preoperative carcinoembryonic antigen levels for the prognosis of patients with well-differentiated gastric cancer. A multivariate analysis.
Serum carcinoembryonic antigen (CEA) levels were determined preoperatively in 221 patients with well-differentiated gastric cancer. The mean preoperative serum CEA level was 15.9 +/- 88.5 ng/ml (1.0-1,133.0 ng/ml) for all patients, and the incidence of an elevated CEA (> 5 ng/ml) was 11.8% (26/221). The CEA-positive patients had larger tumors, a more prominent serosal invasion, more frequent lymphatic and vascular involvement, less expansive tumor growth and higher rates of lymph node and hepatic metastases than did the CEA-negative patients. Thus, the CEA-positive patients had a more advanced stage of disease, and 61.5% underwent noncurative resection (vs. 11.3% in CEA-negative patients). The survival rate of the CEA-positive patients was lower than that of the CEA-negative ones (p < 0.01). As the multivariate analysis revealed the preoperative CEA level to be an independent prognostic factor for survival, an assay for this antigen prior to surgery is to be recommended.
Maehara
Y
Y
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Kusumoto
T
T
Takahashi
I
I
Kakeji
Y
Y
Baba
H
H
Akazawa
K
K
Sugimachi
K
K
D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000601:surgery; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D012044:Regression Analysis; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate
D002272:Carcinoembryonic Antigen