Prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma

// Wei Wang 1,2,* , Xiao-Long Chen 1,2,* , Shen-Yu Zhao 3 , Yu-Hui Xu 3 , Wei-Han Zhang 1,2 , Kai Liu 1,2 , Xin-Zu Chen 1,2 , Kun Yang 1,2 , Bo Zhang 1 , Zhi-Xin Chen 1 , Jia-Ping Chen 1 , Zong-Guang Zhou 1,4 and Jian-Kun Hu 1,2 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China 2 Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China 3 West China School of Medicine, Sichuan University, Chengdu, China 4 Laboratory of Digestive Surgery, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China * These authors have contributed equally to this study and should be considered as co-first authors Correspondence to: Jian-Kun Hu, email: // Keywords : gastric cancer, tumor marker, CA125, CA19-9, CEA Received : September 24, 2015 Accepted : April 05, 2016 Published : April 16, 2016 Abstract The prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma (GC) has been widely reported and is still under debate. Here, we evaluated the prognostic significance of preoperative serum CA125, CA19-9 and CEA in patients with GC. 1692 patients with GC who underwent gastrectomy were divided into the training (from January 2005 to December 2011, n = 1024) and the validation (from January 2012 to December 2013, n = 668) cohorts. Positive groups of CA125 (> 13.72 U/ml), CA19-9 (> 23.36 U/ml) and CEA (> 4.28 ng/ml) were significantly associated with more advanced clinicopathological traits and worse outcomes than that of negative groups (all P < 0.01). In Cox regression analysis, tumor size ( P < 0.001, P = 0.005), pTNM stage ( P < 0.001, P < 0.001) and CA125 ( P = 0.026, P = 0.005) were independent prognostic factors both in two cohorts. Nomograms of these two cohorts based on the number of positive serum tumor markers (NPTM) were more accurate in prognostic prediction than TNM stage alone. Our findings suggested that elevated preoperative serum CA125, CA19-9 and CEA were associated with more advanced clinicopathological traits and less favorable outcomes. In addition, CA125 as an independent prognostic factor should be further investigated. Nomogram based on NPTM could accurately predict the prognosis of GC patients.