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Am Fam Physician. 1998;58(9):2133-2137

Carcinoembryonic antigen (CEA) is widely used for establishing diagnosis, staging, detection of recurrence and prognosis in patients with colorectal cancer. The value of CEA as a tumor marker for gastric carcinoma is less clear. Tachibana and associates measured pre-operative CEA levels in patients with resectable gastric cancer and evaluated the association between serum CEA levels and clinicopathologic features.

A total of 196 consecutive patients who underwent surgery for gastric carcinoma were included in the study. Of these patients, 138 had gastrectomy (70.4 percent), 54 had total gastrectomy (27.6 percent) and four had wedge resection (2.0 percent).

Serum CEA levels were above normal (range: 5.2 to 570 ng per mL [5.2 to 570 μg per L]) in 29 (14.8 percent) of the 196 patients. Of the 100 patients with early gastric cancer confined to the submucosal layer, only seven (7.0 percent) had positive CEA levels (more than 5.0 ng per mL [5.0 μg per L]). Of the 96 patients with advanced cancer, 22 (22.9 percent) had high CEA levels.

The cumulative three- and five-year survival rates in patients who had elevated CEA levels were significantly lower than those for CEA–negative patients. Three and five-year cumulative survival rates in CEA–positive patients were 39.6 percent and 31.7 percent, respectively. In contrast, three- and five-year survival rates in CEA–negative patients were 83.0 percent and 77.3 percent, respectively.

The authors conclude that preoperative serum CEA levels provide predictive information in determining tumor stage and prognosis in patients with potentially resectable gastric cancer.

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Copyright © 1998 by the American Academy of Family Physicians.

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