The clinical significance of ascitic fluid CEA in advanced gastric cancer with ascites.
BACKGROUND
This study was carried out to evaluate the clinical significance of ascitic fluid carcinoembryonic antigen (CEA) in advanced gastric cancer patients with ascites.


METHODS
From November 2001 to February 2008, 119 gastric cancer patients with concurrent ascites who were clinically diagnosed with carcinomatosis, were retrospectively reviewed with regard to ascitic fluid cytology and clinicopathological parameters. Serum CEA (sCEA) and ascitic fluid CEA (aCEA) were measured using a chemiluminescent enzyme immunoassay.


RESULTS
The patients' median age was 50 years (range 23-80 years). The median value of aCEA was significantly higher than sCEA [130.5 ng/ml (range 0.2-12.211 ng/ml) vs. 2.1 ng/ml (range 0.02-8.152 ng/ml), p < 0.001]. Sixty-five patients (54.6%) had positive ascitic fluid cytology. The median overall survival of all patients was 3.0 months (95% CI 2.0-4.0 months). The patients with low aCEA (<5 ng/ml) had a significantly longer overall survival compared to patients with high aCEA (>or=5 ng/ml) (7.4 months vs. 2.3 months, p = 0.003). However, we found no difference in overall survival according to ascitic fluid cytology (median, 3.0 months vs. 2.5 months, p = 0.530). Multivariate analysis also demonstrated that aCEA levels of more than 5 ng/ml were associated with poor prognosis (HR = 2.88; 95% CI 1.45-5.74; p = 0.003), while sCEA levels were not associated with poor prognosis (HR = 1.15; 95% CI 0.67-2.03; p = 0.622).


CONCLUSIONS
These results suggest that aCEA levels can be used as a prognostic marker for advanced gastric cancer patients with ascites.
Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea.
Minkyu
M
Jung
Hei-Cheul
HC
Jeung
Sung Sook
SS
Lee
Jun Yong
JY
Park
Soojung
S
Hong
Soo Hyeon
SH
Lee
Sung Hoon
SH
Noh
Hyun Cheol
HC
Chung
Sun Young
SY
Rha
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000378:metabolism; D001202:Ascitic Fluid / Q000737:chemistry* / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen