Prognostic Value of CEA and Ca 19.9/Tumor Markers in Gastric Cancer to Identify Patients with Poor Prognosis after Radical Surgery

Abstract

Introduction: Although gastric cancer incidence has decreased worldwide, it’ s still the fifth most frequent malignancy and the third leading cause of cancer related mortality. Many prognostic factors have been identified as indicators of gastric cancer prognosis including tumour size, depth, lymph nodes metastasis and microvascular involvement. To date the clinical significance of tumoral markers remains unclear. In our study we would like to investigate the prognostic survival significance of preoperative CEA and CA19.9.Material and Methods: From January 2004 to September 2016, a total of 326 gastric cancer patients were analysed. Of these 260 were enrolled in the study. The two serum tumour markers CEA and CA19.9 were detected within 7 days before surgery. The normal cut off value for serum CEA was 5 ng/ml whereas for CA19.9 was 35 U/ ml. Patients were also dichotomized according to CEA and CA19.9 median value (respectively 2 ng/ml and 9 U/ml).Results: Our results suggest that the optimal application of these common tumour markers could promote the clinical screening and staging of gastric cancer patients. Their evaluation is cheap and easy, allowing a routinely use to identify patients at high risk of death or post-surgical recurrences. Also, we could utilize the optimal cut-off value of CA19.9 for individualizing patients with an early stage but a very bad prognosis.Discussion and Conclusion: We conclude that the combined assessment of CA19.9 and CEA levels could have prognostic value in gastric cancer in particular to identify patients with a poor prognosis after radical surgery, who need an aggressive follow-up and medical treatment.