Department of Surgery, College of Medicine, University of Ulsan and Asan Medical Center, Seoul, Korea.
ABSTRACT
PURPOSE: CEA, CA19-9, and CA72-4 are the most commonly used tumor markers in stomach cancer. This clinical study was performed to evaluate the diagnostic value of these tumor markers in stomach cancer patients.
MATERIALS AND METHODS: A retrospective analysis of 170 stomach cancer patients who had undergone curative gastrectomy between January 1991 and December 1996 at the Department of Surgery was performed. The preoperative and postoperative serum levels of these tumor markers were measured in 170 patients.
RESULTS: The preoperative positive cases were 28 cases (16%) in CEA, 15 (9%) in CA19-9, and 24 (14%) in CA72-4. The postoperative positive cases among 48 recurrences were 21 cases (44%) in CEA, 10 (21%) in CA19-9, and 10 (21%) in CA72-4. The combination of CEA with CA19-9 or CA72-4 had higher positivity rate (58%) than single tumor marker. The highest positivity rate was found in CEA at recurrences of anastomotic site, in CA19-9 at recurrences of lymph node, in CA72-4 at peritoneal seeding and distant metastasis. In multivariate analysis, these tumor markers were not independent prognostic factors.
CONCLUSION: CEA, CA19-9, and CA72-4 have proved unhelpful in initial diagnosis of stomach cancer because of their low positivity rate. And the combination of 3 tumor markers was the useful method for raising positivity rate in diagnosis of recurrences.
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