Prognostic value of preoperative serum tumor markers in gastric cancer.
OBJECTIVE
To evaluate the prognostic value of preoperative carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, and CA50 in patients undergoing D2 resection.


METHODS
We evaluated 363 patients with gastric cancer who underwent gastrectomy at our hospital from January 2006 to December 2009. Blood samples were obtained from each patient within 1 wk before surgery. The cut-off values for serum CEA, CA19-9, and CA50 were 5 ng/mL, 37 U/mL, and 20 U/mL, respectively. The correlation between preoperative tumor marker levels and prognosis was studied by means of univariate and multivariate analyses.


RESULTS
The preoperative serum positive rates of CEA, CA19-9 and CA50 were 24.0%, 18.9% and 24.5%, respectively. The positivity rate of serum CEA was significantly correlated with age (P < 0.001), sex (P = 0.022), tumor size (P = 0.007) and depth of invasion (P = 0.018); CA19-9 with tumor size (P = 0.042) and lymph node metastasis (P < 0.001); and CA50 only with lymph node metastasis (P = 0.001). In multivariate analysis, tumor size, T category, N category, vascular or neural invasion, and adjuvant chemotherapy were independent prognostic factors for overall survival. CA19-9 had an independent prognostic significance in patients without adjuvant chemotherapy (P = 0.027).


CONCLUSIONS
Preoperative serum CEA, CA19-9 and CA50 are prognostic in patients with gastric cancer. Only CA19-9 is an independent prognostic factor after surgery without adjuvant chemotherapy.
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Ze-Bo
ZB
Huang
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Xin
X
Zhou
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Jun
J
Xu
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Yi-Ping
YP
Du
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Wei
W
Zhu
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Jian
J
Wang
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Yong-Qian
YQ
Shu
Ze-Bo Huang, Xin Zhou, Jun Xu, Yi-Ping Du, Wei Zhu, Jian Wang, Yong-Qian Shu, Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Ping
P
Liu
Cancer antigen 19-9; Cancer antigen 50; Carcinoembryonic antigen; Gastric cancer; Prognosis