Prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma.

Wei Wang,Xin-Zu Chen,Xiao-Long Chen,Bo Zhang,Kai Liu,Jian-Kun Hu,Kun Yang,Zong-Guang Zhou,Jia-Ping Chen,Shen-Yu Zhao,Zhi-Xin Chen,Wei-Han Zhang,Yu-Hui Xu

doi:10.18632/oncotarget.8770

Wei Wang, Xin-Zu Chen + Show 11 more

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https://doi.org/10.18632/oncotarget.8770

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Abstract

The prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma (GC) has been widely reported and is still under debate. Here, we evaluated the prognostic significance of preoperative serum CA125, CA19-9 and CEA in patients with GC. 1692 patients with GC who underwent gastrectomy were divided into the training (from January 2005 to December 2011, n = 1024) and the validation (from January 2012 to December 2013, n = 668) cohorts. Positive groups of CA125 (> 13.72 U/ml), CA19-9 (> 23.36 U/ml) and CEA (> 4.28 ng/ml) were significantly associated with more advanced clinicopathological traits and worse outcomes than that of negative groups (all P < 0.01). In Cox regression analysis, tumor size (P < 0.001, P = 0.005), pTNM stage (P < 0.001, P < 0.001) and CA125 (P = 0.026, P = 0.005) were independent prognostic factors both in two cohorts. Nomograms of these two cohorts based on the number of positive serum tumor markers (NPTM) were more accurate in prognostic prediction than TNM stage alone. Our findings suggested that elevated preoperative serum CA125, CA19-9 and CEA were associated with more advanced clinicopathological traits and less favorable outcomes. In addition, CA125 as an independent prognostic factor should be further investigated. Nomogram based on NPTM could accurately predict the prognosis of GC patients.

Highlights

Gastric carcinoma (GC) is one of the most common malignant tumors with high mortality worldwide, especially in East Asia, and the five-year survival rate of gastric carcinoma (GC) is low [1,2,3]
Our findings suggested that elevated preoperative serum carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) were associated with more advanced clinicopathological traits and less favorable outcomes
As to lymph node metastasis, the proportions of N+ were 74.8% for CA125 (+), 84.9% for CA19-9 (+) and 84.3% for CEA (+), and it rose to 94.7% when three tumor markers were simultaneously positive (Table 3)

Summary

Introduction

Gastric carcinoma (GC) is one of the most common malignant tumors with high mortality worldwide, especially in East Asia, and the five-year survival rate of GC is low [1,2,3]. CA19-9 is a specific marker of www.impactjournals.com/oncotarget digestive system tumors, especially pancreatic cancer, with high positive rate preoperatively and high negative rate postoperatively [8]. It is widely used in the diagnosis and monitoring of pancreatic cancer [9]. The three tumor markers are detected preoperatively, they are hardly used for the diagnosis of GC because of the poor sensitivity and specificity [11, 12] They can be applied in the evaluation of therapeutic effect, monitoring of recurrence and prediction of prognosis [13, 14]

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