The Prognostic Significance of the Preoperative Serum CEA, CA19-9 and AFP Levels in Gastric Cancer Patients

Na, Kuk Young; Chang, Yeon Soo; Kim, Yong Ho; Joo, Sun Hyung; Lee, Suk Hwan

Abstract

PURPOSE
No tumor-specific markers for gastric cancer are currently known, although various tumor markers have been utilized. CEA, CA19-9 and AFP are the most commonly used tumor markers for gastric cancer. The aim of this study is to evaluate the prognostic significance of the preoperative CEA, CA19-9 and AFP levels in patients with gastric cancer.
METHODS
A total of 366 patients who underwent curative surgery for gastric cancer were analyzed. The clinicopathologic characteristics and disease-free survival rate of the patients were compared between the positive and negative CEA, CA19-9 and AFP groups of patients, respectively. Also, the prognostic significance of each tumor marker was assessed by multivariate analysis.
RESULTS
The CEA, CA19-9 and AFP levels were elevated in 14.2%, 7.9% and 19.1% of the patients, respectively. Serosal invasion and advanced cancer were more frequently found in the groups of patients who were positive for CEA and CA19-9 (P<0.05). More lymph node metastasis and an advanced tumor stage were found in the group of patients who were positive for CA19-9 (P<0.05). On univariate analysis, the disease-free survival rate was significantly lower in the CA19-9 positive group (P<0.05). Serosal invasion and lymph node metastasis were the only significant prognostic factors on multivariate analysis.
CONCLUSION
CEA, CA19-9 and AFP have proved unhelpful for the early detection of gastric cancer due to the low positive rate. CEA and AFP have no prognostic significance and only CA19-9 can be useful for estimating the severity of gastric cancer and as a limited prognostic factor for gastric cancer patients.