Prognostic Value of Preoperative Serum Levels of Five Tumor Markers (Carcinoembryonic Antigen, CA19-9, Alpha-fetoprotein, CA72-4, and CA125) in Gastric Cancer.

Background/aims: There is no known specific tumor marker for gastric cancer, although several tumor markers have been used. The aim of this study was to investigate the prognostic significance of preoperative carcinoembryonic antigen (CEA), CA 19-9, alpha-fetoprotein (AFP), CA 72-4, and CA 125 levels in patients with gastric cancer.

Methodology: Medical records of 1,253 patients who were diagnosed with gastric adenocarcinoma were retrospectively reviewed. The clinicopathologic characteristics and disease-free survival rate of the patients were compared between positive and negative CEA, CA 19-9, AFP, CA 72-4, and CA 125 groups of patients. Additionally, the prognostic significance of each tumor marker was assessed by multivariate analysis.

Results: CEA, CA19-9, and CA72-4 were more frequently positive in patients with lymphatic and venous invasion, serosal involvement, and lymph node metastasis. The 5-year overall survival and disease free survival rates were significantly associated with elevated serum levels of CEA, CA 19-9, and CA 72-4. The depth of invasion and CA 19-9 were independent prognostic factors. Patients with elevated serum levels of CA 19-9 showed a 3.35-fold higher risk of death than patients with low levels of the marker.

Conclusions: CA 19-9 has prognostic significance in gastric cancer, and a high preoperative serum level of CA 19-9 can be useful for estimating worse prognosis and a higher recurrence of gastric cancer.