title: Predictive value of preoperative serum CEA, CA19-9 and CA125 levels for peritoneal metastasis in patients with gastric carcinoma.
abstract: 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.
authors.affiliation: Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Gun Ick
authors.initials: GI
authors.lastname: Hwang
authors.forename: Chang Hak
authors.initials: CH
authors.lastname: Yoo
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Sohn
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Shin
authors.forename: Yong Lai
authors.initials: YL
authors.lastname: Park
authors.forename: Heung Dai
authors.initials: HD
authors.lastname: Kim
authors.forename: Yong Shin
authors.initials: YS
authors.lastname: Kim
authors.forename: Won Kon
authors.initials: WK
authors.lastname: Han
authors.forename: Won Kil
authors.initials: WK
authors.lastname: Pae
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