Early prediction of tumor recurrence after curative resection of gastric carcinoma by measuring soluble E-cadherin.
BACKGROUND
Currently, to the authors' knowledge, there is no serum marker to predict disease recurrence after patients undergo curative resection for gastric carcinoma. Previous reports have indicated that serum levels of soluble E-cadherin had prognostic value in these patients. The objective of the current study was to determine whether soluble E-cadherin levels could predict disease recurrence in patients with gastric carcinoma who underwent curative surgery.


METHODS
Sixty-nine patients who underwent curative surgery for gastric carcinoma after December 1997 were followed prospectively. Venous blood samples were collected preoperatively, 1 month after surgery, and every 3 months thereafter. The blood samples were assayed for soluble E-cadherin and for carcinoembryonic antigen (CEA) using commercial enzyme-linked immunosorbent assay kits. Receiver operating characteristic (ROC) curves were used to define a cut-off level of E-cadherin for the optimal sensitivity and specificity for predicting disease recurrence.


RESULTS
The median follow-up was 21 months for patients with recurrent disease (n = 17 patients) and 36 months for patients without recurrent disease (n = 52 patients; P = 0.007). The optimal cut-off level of E-cadherin was 10,000 ng/mL. The sensitivity for predicting prediction disease recurrence using this cut-off level at 3 months and at 6 months postsurgery was 47% and 59% respectively, which was significantly better compared with the sensitivity of CEA using the conventional cut-off level (6% at 3 months postsurgery and 6% at 6 months postsurgery; P = 0.004 and P < 0.0001, respectively). The median time between the elevated E-cadherin level and documented disease recurrence was 13 months (range, 3-20 months), compared with 4 months (range, 1-20 months) for CEA.


CONCLUSIONS
Serum soluble E-cadherin was a good marker for predicting disease recurrence in the first 3-6 months after surgery, with a median of 13 months before clinical recurrence. The use of this marker may allow time for vigilant surveillance and consideration of adjuvant therapy.
Chan
Annie On On
AO
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Chu
Kent-Man
KM
Lam
Shiu Kum
SK
Cheung
Kwan Lok
KL
Law
Simon
S
Kwok
Ka-Fai
KF
Wong
Wai Man
WM
Yuen
Man Fung
MF
Wong
Benjamin Chun-Yu
BC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D015820:Cadherins / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D013505:Digestive System Surgical Procedures; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000601:surgery*
D014408:Biomarkers, Tumor; D015820:Cadherins; D002272:Carcinoembryonic Antigen