title: Prognostic values of normal preoperative serum cancer markers for gastric cancer.
abstract: We examined the prognostic value of normal levels of four serum cancer markers, carcinoembryonic antigen (CEA), carbohydrate associated antigen (CA19-9), alpha-fetoprotein (AFP) and cancer antigen 125 (CA125), in gastric cancer patients. Among 1927 gastric cancer patients enrolled in this study, 1477 were male (76.6%) and 450 were female (23.4%). The median age was 57 years (range 20-86). Clinicopathological features and survival times were recorded, and the association between CEA, CA19-9, AFP, and CA125 levels and patient prognosis was analyzed. The optimal cut-off values were 0.71 for CEA (P=0.317), 9.22 for CA19-9 (P=0.009), 3.76 for AFP (P=0.008) and 15.65 for CA125 (P=0.006). Serum CA19-9 levels correlated with gender, age, and tumor depth (all P<0.05); AFP levels correlated with pathological type (P=0.005); and CA125 levels correlated with gender, tumor size, pathological type, tumor depth and lymph node metastasis (all P<0.05). Relatively high levels of CA19-9, AFP and CA125, still within the normal range, were all associated with poor prognosis (5-year overall survival: 70.6% vs 64.2%, P<0.001. 69.6% vs 54.5%, P=0.011. 70.2% vs 54.9%, P<0.001). However, only CA19-9 and AFP levels were independent prognostic predictors. We conclude that the combined assessment of CA19-9, AFP and CA125 levels could have prognostic value in gastric cancer (P<0.001).
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Feng
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Shushang
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Gaozan
authors.initials: G
authors.lastname: Zheng
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Man
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lian
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Daiming
authors.initials: D
authors.lastname: Fan
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000378:metabolism; D018395:CA-19-9 Antigen / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D000509:alpha-Fetoproteins
keywords: AFP; CA125; CA19-9; gastric cancer; prognosis