Cancer Res Treat.  2004 Jun;36(3):178-181.

Predictive Value of Preoperative Serum CEA, CA19-9 and CA125 Levels for Peritoneal Metastasis in Patients with Gastric Carcinoma

• Hwang GI
• Yoo CH
• Sohn BH
• Shin JH
• Park YL
• Kim HD
• Kim YS
• Han WK
• Pae WK

Abstract

PURPOSE
Peritoneal metastasis is a crucial factor for the prognosis in gastric cancer, but its diagnosis is difficult before laparotomy. This study analyzed the usefulness of diagnostic imaging and various tumor markers in the detection of peritoneal metastasis in gastric cancer.
MATERIALS AND METHODS
The sera from 768 patients with gastric cancer were measured for CEA, CA19-9 and CA125 levels using a commercial immunoradiometric assay. All the patients underwent diagnostic imaging with computed tomography (CT) and ultrasound (US) before laparotomy.
RESULTS
Preoperative levels of CEA, CA19-9 and CA125 were above the cut-off levels in 15.4%, 8.7% and 5.7% of all cases, respectively. Eighty-eight patients were diagnosed with peritoneal metastasis by laparotomy. CT and US revealed peritoneal dissemination in 15 of 88 patients (17%). Among the three tumor markers, CA19-9 and CA125 showed similar detection rates of peritoneal metastasis (37.5% and 38.6%, respectively). In particular, the serum CA125 levels showed the best sensitivity (38.6%), specificity (98.4%), and diagnostic accuracy (91.5%), and the highest odd ratio (24.46, 95% CI: 11.17~53.57) for predicting peritoneal metastasis among the markers tested. CEA did not add significant predictive information (p=0.471).
CONCLUSION
Preoperative serum CA19-9 and CA125 levels may provide a predictable value in determining peritoneal metastasis in patients with gastric cancer.

Keyword

Stomach neoplasm; CEA; CA19-9; CA125; Peritoneal metastasis

MeSH Terms

Diagnosis
Diagnostic Imaging
Humans
Immunoradiometric Assay
Laparotomy
Neoplasm Metastasis*
Prognosis
Sensitivity and Specificity
Stomach Neoplasms
Biomarkers, Tumora
Ultrasonography

Figure

• 

  Fig. 1 Comparison of diagnostic ability of peritoneal metastasis by each tumor marker. Solid bar: sensitivity; open bar: specificity; shaded bar: diagnostic accuracy. Sensitivity=(patients with peritoneal metastasis with positive tests/all patients with peritoneal metastasis tested) ×100; Specificity=(patients without peritoneal metastasis with negative tests/all patients without peritoneal metastasis tested) ×100; Diagnostic accuracy=(patients with peritoneal metastasis with positive tests+patients without peritoneal metastasis with negative tests)/(all patients tested) ×100.

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