Drainage of CEA and CA19-9 to the Peripheral Blood in Gastric Cancer Patients

Tadatsugu Hirose, Kimio Namatame

Department of Surgery, Showa University Fujigaoka Hospital

To define the route by which carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) reach the peripheral blood, we conducted simultaneous intraoperative blood sampling from a peripheral vein, a tumor draining vein, and the portal vein for detection of these tumor-associated antigens. In addition, clinicopathological and immunohistochemical evaluations were performed of the primary tumors and involved lymph nodes. The results were as follows: 1) Higher CEA levels were found in the tumor draining vein and portal vein than in the periphersal vein. Significantly higher levels were found in the patients with liver metastasis. 2) CEA levels were related to venous invasion, and CA19-9 levels to lymphatic invasion and lymph node involvement. 3) In the patients with a localized pattern of primary lesions (Stromal type), higher CEA levels were obtained in the tumor draining vein and portal vein than in the peripheral vein. 4) On immunohistochemical lymph node staining, CA19-9 showed a higher positive rate than CEA. Additionally, peripheral venous CA19-9 showed a higher positive rate than CEA. Additionally, peripheral venous CA19-9 levels were significantly higher in the patients with positive lymph node staining than in those withosut it. These results may indicate that CEA drains from tumors via the portal vein, while CA19-9 drains via the lymphatics and the thoracic duct.

Key words
gastric cancer, carcinoembryonic antigen, carbohydrate antigen 19-9, draining venous blood from tumors, immunohistochemical staining

Reprint requests
Tadatsugu Hirose Department of Surgery, Showa University Fujigaoka Hospital
1-30 Fujigaoka, Midoriku, Yokohama, 227 JAPAN

Accepted
May 11, 1994

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