Background/aims: The present study aim is to study the significance of serum tumor markers in predicting tumor progression and clinical outcomes in gastric cancer (GC).
Methodology: Preoperative serum tumor markers were determined in 166 GC patients, who were followed after curative gastrectomy. The associations between tumor marker status and tumor invasion depth, clinical stage, lymph node metastasis, and survival were analyzed.
Results: Carcinoembryonic antigen (CEA) was significantly correlated with serosal invasion of the stomach and clinical stage, and carbohydrate antigen 19-9 (CA19-9) related to the clinical stage (p < 0.05). Patients with more markers positive had a shorter survival, 19.0, 11.0 and 3.0 months median survival time for one, two and three markers positive, respectively (p < 0.01). CA19-9, CEA and cancer antigen 125 (CA125) were more sensitive and specific in predicting worse prognosis than diagnosis. Multivariate analysis showed that CA19-9 and clinical stage were independent prognostic factors (p < 0.05). The degree of the CA19-9 elevation had a modest negative correlation with survival (r = -0.466, p = 0.008).
Conclusions: Increased preoperative CEA level signifies tumor invasion into the serosa of the stomach, which may call for new therapies. CA19-9 is an independent negative prognostic factor.