Cancer Res Treat.  2008 Mar;40(1):16-21.

Prognostic Significance of Serum and Tissue Carcinoembryonic Antigen in Patients with Gastric Adenocarcinomas

• Park SH
• Ku KB
• Chung HY
• Yu W

Abstract

PURPOSE: Carcinoembryonic antigen (CEA) is known to be elevated in nearly all solid malignancies. The prognostic role of CEA in gastric cancers however, is still controversial. We evaluated preoperative serum CEA levels and CEA expression from the resected tumor tissues to determine whether they have prognostic significance in gastric cancer patients.
MATERIALS AND METHODS
Medical records of 810 patients who underwent surgery for gastric adenocarcinoma from June, 1998 to February, 2002 in Kyungpook National University Hospital were reviewed. Serum CEA level was evaluated by radioimmunoassay preoperatively, and the cut-off level for positivity was 7.0 ng/ml. Labeled streptavidin-biotin peroxidase method was used to determine CEA expression from the gastric cancer tissues.
RESULTS
Serum and tissue CEA were positive in 9.3% and 91.1% of the patients, respectively. They had no correlation with each other. The positivity rate of serum CEA had positive correlation with invasion depth (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.006), and final stage (p<0.001). Well differentiated tumors showed higher serum CEA positivity (p=0.002). Patients with positive serum CEA had higher recurrence rate (p<0.001). Multivariate analysis showed significantly lower survival rate in patients with preoperative CEA levels over 7 ng/ml than those with lower levels (48.0% vs. 80.7%; p<0.001). The positivity rates of tissue CEA were higher in advanced cancers (p=0.033) and in more advanced stages (p=0.029). Tissue CEA positivity showed no correlation with recurrence or survival.
CONCLUSIONS
Preoperative serum CEA level had correlation with disease progression and survival in gastric cancer patients, and proved to be an independent prognostic factor. Tissue CEA expression in gastric cancers had no prognostic information.

Keyword

Carcinoembryonic antigen; Stomach Neoplasms; Preoperative serum level; Immunohistochemical stain; Prognostic factor

MeSH Terms

Adenocarcinoma
Carcinoembryonic Antigen
Disease Progression
Humans
Lymph Nodes
Medical Records
Multivariate Analysis
Neoplasm Metastasis
Peroxidase
Radioimmunoassay
Recurrence
Stomach Neoplasms
Survival Rate
Carcinoembryonic Antigen
Peroxidase

Figure

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  Fig. 1 Detection of the expression of carcinoembryonic antigenb (CEA) from the tumor tissue by immunohistochemistry (×100). The cytoplasm is strongly stained in comparison to nuclei or adjacent stroma.

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  Fig. 2 Survival curves of the patients according to the serum positivity of carcinoembryonic antigen (CEA):broken line, negative CEA; solid line, positive CEA (p<0.001).

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