Role of Serum Tumor Markers in Monitoring for Recurrence of Gastric Cancer Following Radical Gastrectomy

Abstract

It has been suggested that the serum tumor markers AFP, CEA, and CA19-9 may serve as prognostic factors or indicators for recurrence after radical gastrectomy for gastric cancer. We compared the value of these markers in a group with (n=52) and a group without recurrent gastric cancer (n=52) according to the site of recurrence. Serum levels of tumor markers were measured at the time of preoperative diagnosis and at follow-up. At least one tumor marker was positive preoperatively in 20 with recurrence vs. 7 controls (p=0.007). The peritoneum was the most common recurrent site. The positive predictive value of AFP was high at the time of diagnosis and CA19-9 positivity was high at the time of recurrence. Positive CEA suggested recurrence to the liver. In summary, an elevated tumor marker at diagnosis or during follow up may identify patients at higher risk for a recurrence. CA19-9 may be especially useful as a marker for peritoneal recurrence of the gastric cancer, and CEA for recurrence to liver.

Combined Detection of CEA, CA 19-9, CA 242 and CA 50 in the Diagnosis and Prognosis of Resectable Gastric Cancer

“…Duraker et al (Duraker et al, 2001) reported that no correlation exists between CA 19-9 positivity and lymph node, hepatic and peritoneal metastasis, and no relationship was found between CEA positivity and tumor size, and hepatic and peritoneal metastasis. Choi et al analyzed gastric cancer patients with and without recurrence, and found that CA 19-9 may be useful as a marker for peritoneal recurrence, whereas CEA may be a useful marker for hepatic recurrence (Choi et al, 2006). Another study conducted in Korea found that there was no significant association between CA 19-9 and depth of invation, nodal involvement and staging except metastasis, CEA did not show statistically significant relationship with nodal involvement, depth of invasion and stage (Gwak et al, 2014).…”

Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association

“…They also reported false-positive rates of CEA, CA19-9, CA72-4, and the triple markers were 5.6, 7.0, 9.9, and 18.3 %, respectively [64]. Choi et al [65] reported that the majority (90 %) of cases with recurrence to the liver had an elevated CEA, whereas an elevated CA 19-9 postoperatively was more predictive of a peritoneal recurrence (78.9 %). CA19-9 may be particularly useful as a marker of peritoneal recurrence, whereas CEA could be a useful marker for recurrence in the liver [65].…”

“…Choi et al [65] reported that the majority (90 %) of cases with recurrence to the liver had an elevated CEA, whereas an elevated CA 19-9 postoperatively was more predictive of a peritoneal recurrence (78.9 %). CA19-9 may be particularly useful as a marker of peritoneal recurrence, whereas CEA could be a useful marker for recurrence in the liver [65]. Therefore, the patients should have a set of markers evaluated once preoperatively.…”

Serum interleukin-6 and -10 levels in patients with gastric cancer

“…Serum CEA levels less than 5 ng/ml, serum CA19-9 levels less than 35 U/ml, and serum CRP levels less than 0.2 mg/dl were taken as the normal ranges [19,20].…”