Preoperative CEA and TAG-72 serum levels as prognostic indicators in resectable gastric carcinoma.

Abstract

We evaluated in 74 patients with resectable primary gastric carcinoma, the prognostic value of the preoperative circulating serum levels of CEA and TAG-72. Serum levels of CEA were above the cutoff level of 6 ng/ml in 18.9% of patients; TAG-72 levels were higher than 6 U/ml in 31% of patients. Pretreatment mean CEA levels were significantly lower (p < 0.01) in patients with stage I tumors (2.9 +/- 0.3 ng/ml) than in those with more advanced tumors (stage II: 14.5 +/- 6.8 ng/ml; stage III-IV: 6.8 +/- 1.5 ng/ml). Similarly, significant differences in mean TAG-72 serum levels were found between stage I (3.5 +/- 1.8 U/ml) and stage II and stage III-IV (30.4 +/- 20.7 U/ml and 26.1 +/- 9.7 U/ml, respectively) (p < 0.05). In addition, TAG-72 levels were also higher in poorly differentiated and moderately differentiated tumors (38.5 +/- 20.1 U/ml and 23.1 +/- 9.4 U/ml, respectively) than in well differentiated tumors (4.4 +/- 0.9 U/ml) (p < 0.05). The results further indicated that high preoperative serum levels of CEA predicted shorter relapse-free survival duration (p < 0.01), and that high TAG-72 levels were associated with shorter relapse-free and overall survival (p < 0.0001 and p < 0.0005, respectively). In addition, separate Cox multivariate analysis showed that preoperative TAG-72 was, after stage, the strongest factor to predict both relapse-free and overall survival (p < 0.0001 and p < 0.005, respectively) in patients with gastric cancer.