Preoperative serum CEA and CA19-9 in gastric cancer--a single tertiary hospital study of 1,075 cases.

Yang-Chun Zhou,Hai-Jian Zhao,Li-Zong Shen

doi:10.7314/apjcp.2015.16.7.2685

Yang-Chun Zhou, Hai-Jian Zhao + Show 1 more

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https://doi.org/10.7314/apjcp.2015.16.7.2685

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Abstract

To evaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable gastric cancer (GC), a total of 1,075 consecutive cases with gastric adenocarcinoma were obtained retrospectively from January 2012 and December 2013 in a single tertiary hospital, and the relationships between serum CEA, CA19-9 and clinicopathologic features were investigated. Positive preoperative serum rates of CEA and CA19-9 were 22.4% and 12.3% respectively, levels significantly correlating with each other and depth of invasion, lymph node involvement, pTNM and stage. The CEA level also presented a remarkable association with lymphovascular invasion. Both CEA and CA19-9 positivity significantly and positively correlated with depth of invasion, nodal involvement, pTNM stage, lymphovascular invasion, tumor size and tumor location. Stratified analyses according to gender or tumor location showed preoperative CEA or CA19-9 had different associations with clinicopathologic features in different gender subgroups or location subgroups. Preoperative serum CA19-9 positivity may be more meaningful for tumor size rather than CEA. In conclusion, preoperative serum CEA and CA19-9 correlate with disease progression of GC, and may have applications in aiding more accurate estimation of tumor stage, decision of treatment choice and prognosis evaluation.

Highlights

In spite of the fact that the incidence and mortality rate of gastric cancer (GC) have declined markedly over the past decades in western and eastern countries, gastric cancer remains one of the most common and lethal malignancies worldwide (Jemal et al, 2011)
A total of 241 (22.4%) patients were positive for serum carcinoembryonic antigen (CEA) and 132 (12.3%) patients were seropositive for CA19-9
The distributions of serum CEA, CA19-9 were skewed (Figure 1), and their distributions according to pathologic T classification, N classification, TNM stage and lymphovascular invasion were shown in Figure 2 and Figure 3 respectively

Summary

Introduction

In spite of the fact that the incidence and mortality rate of gastric cancer (GC) have declined markedly over the past decades in western and eastern countries, gastric cancer remains one of the most common and lethal malignancies worldwide (Jemal et al, 2011). There are no specific TMs for gastric cancer by far, and carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA199) are the most commonly used alternatives (Fan et al, 2011; Dilege et al, 2010; Shimada et al, 2014) Both CEA and CA19-9 have shown little benefit to screen early primary GC in the general population due to low sensitivity and specificity, they mainly be used for the monitoring of tumor recurrence and used as prognostic factors (Park et al, 2008; Marrelli et al, 1999; Shimada et al, 2014). To reevaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable GC, we collected the clinical data of large volume of patients with GC in a single tertiary hospital, and investigated the correlation of preoperative serum CEA, CA19-9 with clinicopathologic features in the present retrospective study

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