Predictive value of preoperative serum CEA, CA19-9 and CA125 levels for peritoneal metastasis in patients with gastric carcinoma.
OBJECTIVE
Peritoneal metastasis is a crucial factor for the prognosis in gastric cancer, but its diagnosis is difficult before laparotomy. This study analyzed the usefulness of diagnostic imaging and various tumor markers in the detection of peritoneal metastasis in gastric cancer.


METHODS
The sera from 768 patients with gastric cancer were measured for CEA, CA19-9 and CA125 levels using a commercial immunoradiometric assay. All the patients underwent diagnostic imaging with computed tomography (CT) and ultrasound (US) before laparotomy.


RESULTS
Preoperative levels of CEA, CA19-9 and CA125 were above the cut-off levels in 15.4%, 8.7% and 5.7% of all cases, respectively. Eighty-eight patients were diagnosed with peritoneal metastasis by laparotomy. CT and US revealed peritoneal dissemination in 15 of 88 patients (17%). Among the three tumor markers, CA19-9 and CA125 showed similar detection rates of peritoneal metastasis (37.5% and 38.6%, respectively). In particular, the serum CA125 levels showed the best sensitivity (38.6%), specificity (98.4%), and diagnostic accuracy (91.5%), and the highest odd ratio (24.46, 95% CI: 11.17 approximately 53.57) for predicting peritoneal metastasis among the markers tested. CEA did not add significant predictive information (p=0.471).


CONCLUSIONS
Preoperative serum CA19-9 and CA125 levels may provide a predictable value in determining peritoneal metastasis in patients with gastric cancer.
Hwang
Gun Ick
GI
Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yoo
Chang Hak
CH
Sohn
Byung Ho
BH
Shin
Jun Ho
JH
Park
Yong Lai
YL
Kim
Heung Dai
HD
Kim
Yong Shin
YS
Han
Won Kon
WK
Pae
Won Kil
WK
World J Surg. 1995 Jan-Feb;19(1):133-7; discussion 137
7740800
Endoscopy. 2002 Jul;34(7):569-74
12170412
Cancer. 1998 Dec 15;83(12):2488-92
9874453
Am J Gastroenterol. 1996 Jan;91(1):49-53
8561143
Hepatogastroenterology. 2002 Jul-Aug;49(46):1157-60
12143226
Tumour Biol. 2001 Sep-Oct;22(5):318-22
11553862
Am J Surg. 1999 Sep;178(3):256-62
10527450
Oncology. 2003;65(1):1-6
12837976
Int J Gynecol Pathol. 1983;2(3):275-85
6196309
Br J Cancer. 1984 Dec;50(6):765-9
6208925
Gastric Cancer. 2003;6(3):142-5
14520526
Surg Endosc. 1997 Dec;11(12):1159-62
9373285
Gastric Cancer. 1998 Dec;1(1):10-24
11957040
Ann Surg Oncol. 2003 Mar;10(2):150-4
12620910
J Surg Oncol. 1998 Oct;69(2):71-5
9808508