Significance of Carcinoembryonic Antigen Levels in Peritoneal Washings for Gastric Cancer Patients

Oh, Dong Joon; Kim, Jin Young

Abstract

Carcinoembryonic antigen (CEA) levels were determined in peritoneal washings from 42 patients who recieved explo-laparatomies from Jan. to Dec. 1995, and these were compared with blood CEA and peritoneal cytology. The patients consisted of 9 patients with benign diseases, 11 with gastric cancer without serosal invasion, 15 with gastric cancer with serosal invasion, and 7 with gastric cancer with visible peritoneal dissemination. Positive values (> 100 ng/g of protein) of peritoneal CEA were observed in 15 cases (45.5%) among 33 gastric cancer patients: 6 (85.7%) of the 7 patients with gastric cancer with visible dissemination, 7 (46.7%) of the 15 patients with serosal invasion without peritoneal dissemination, and 2 of the 11 patients with no serosal invasion, however, no elevation was observed in the 9 patients with benign diseases. The blood CEA and the peritoneal cytology were positive in 8 (24.2%) and 3 (10%) out of the 33 gastric cancer patients, respectively. The sensitivity for peritoneal dissemination was better in peritoneal CEA than in blood CEA and peritoneal cytology. The 1-year survival rates for the patients with and without elevations of the CEA levels were 46.7% and 94.4%, respectively (p < 0.001). The cause of death in 7 (87.5%) of the 8 patients with elevated CEA level in their peritoneal washings could be a sensitive detector of peritoneal dissemination as well as a new predictor for the postoperative prognosis of gastric cancer and an indication for intraperitoneal chemotherapy of hyperthermia.