Evaluation of Serum Levels of CEA and CA19-9 as Parameters of Following Up for Patients with Gastric Cancer

Etsuro Bando, Yasuo Takeshita, Katsuhiro Yoshimoto, Go Minatoya, Yutaka Yoshimitsu and Yoshiaki Isobe

Department of Surgery, Maizuru Kyousai Hospital

Serum levels of CEA and CA19-9 antigens were measured in 237 patients with gastric cancer pre- and post-operatively. The rates of positive preoperative serum levels of CEA and CA19-9 were both 15.6%. In stage I disease, the elevated levels of the 2 markers were 4.2%, 2.5%, respectively. In the patients with a negative pre-operative serum level of CEA/CA19-9 who underwent curative resection, the prognosis for those with a negative post-operative serum level of CEA/CA19-9 was significantly better than for those with elevated post-operative levels (p<0.001, p<0.001). In the patients with a positive preoperative serum level of CEA/CA19-9, the survival rate for those with a negative level of post-operative serum CEA/CA19-9 was significantly higher than for those with elevated post-operative levels (p=0.006, p=0.019). The combination assay of the 2 antigens had sensitivity, specificity and accuracy of 73.0%, 90.1% and 86.0% in 48 recurrent cases. Furthermore, multivariate analysis using logistic regression analysis showed that the depth of tumor invasion (p=0.023) and post-operative positive level of CEA/CA19-9 (p<0.001) were independent variables for recurrence in the patients who underwent curative resection. In conclusion, pre-operative measuring of the serum level of both CEA and CA19-9 were not useful for detecting the early stage of gastric cancer, however, postoperative measurement of those tumor markers could be useful in following up patients after surgery for gastric carcinoma.

Key words
carcinoembryonic antigen, carbohydrade antigen 19-9, early detection for recurrence in gastric cancer

Reprint requests
Etsuro Bando 2nd Department of Surgery, School of Medicine, Kanazawa University 13-1 Takara-machi, Kanazawa, 920-0934 JAPAN

Accepted
October 14, 1998

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