title: Carcinoembryonic antigen level is related to tumor invasion into the serosa of the stomach: study on 166 cases and suggestion for new therapy.
abstract: OBJECTIVE
  The present study aim is to study the significance of serum tumor markers in predicting tumor progression and clinical outcomes in gastric cancer (GC).
  
  
  METHODS
  Preoperative serum tumor markers were determined in 166 GC patients, who were followed after curative gastrectomy. The associations between tumor marker status and tumor invasion depth, clinical stage, lymph node metastasis, and survival were analyzed.
  
  
  RESULTS
  Carcinoembryonic antigen (CEA) was significantly correlated with serosal invasion of the stomach and clinical stage, and carbohydrate antigen 19-9 (CA19-9) related to the clinical stage (p < 0.05). Patients with more markers positive had a shorter survival, 19.0, 11.0 and 3.0 months median survival time for one, two and three markers positive, respectively (p < 0.01). CA19-9, CEA and cancer antigen 125 (CA125) were more sensitive and specific in predicting worse prognosis than diagnosis. Multivariate analysis showed that CA19-9 and clinical stage were independent prognostic factors (p < 0.05). The degree of the CA19-9 elevation had a modest negative correlation with survival (r = -0.466, p = 0.008).
  
  
  CONCLUSIONS
  Increased preoperative CEA level signifies tumor invasion into the serosa of the stomach, which may call for new therapies. CA19-9 is an independent negative prognostic factor.
authors.affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, No 169, Donghu Road, Wuhan 430071, China.
authors.forename: Yan-Hua
authors.initials: YH
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Chuang
authors.initials: C
authors.lastname: Chen
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D013274:Stomach Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000628:therapy
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; C074601:CA 242 antigen; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen