Prognostic significance of pretreatment serum carcinoembryonic antigen levels in gastric cancer with pathological lymph node-negative: A large sample single-center retrospective study

• Published in: World journal of gastroenterology : WJG Vol. 23; no. 48; pp. 8562 - 8569
• Main Authors: Xiao, Jun, Ye, Zai-Sheng, Wei, Sheng-Hong, Zeng, Yi, Lin, Zhen-Meng, Wang, Yi, Teng, Wen-Hao, Chen, Lu-Chuan
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.12.2017
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoembryonic Antigen - blood; Carcinoma - blood; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - surgery; Female; Gastrectomy; GPI-Linked Proteins - blood; Humans; Kaplan-Meier Estimate; Lymph Nodes - pathology; Male; Middle Aged; Neoplasm Invasiveness - pathology; Preoperative Period; Prognosis; Retrospective Studies; Retrospective Study; Stomach Neoplasms - blood; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Survival Rate; Young Adult; Carcinoembryonic antigen; 5-year survial rate; X-tile plots; Gastric cancer; Pathological lymph node-negative
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v23.i48.8562

To assess whether elevated serum carcinoembryonic antigen (CEA) is in the inferior prognosis for pathological lymph node-negative (pN ) gastric cancer (GC) patients who underwent D gastrectomy. About 469 pN GC patients, who received D radical gastrectomy were retrospectively analyzed. The X-tile plots cut-off point for CEA were 30.02 ng/mL using minimum -value from log-rank χ statistics, and pN GC patients were assigned to two groups: those more than 30.02 ng/mL ( = 48; CEA-high group) and those less than 30.02 ng/mL ( = 421; CEA-low group). Clinicopathologic characteristics were compared using Pearson's χ or Fisher's exact tests, and survival curves were so manufactured using the Kaplan-Meier method. Univariate and multivariate analysis were carried out using the logistic regression method. The percentage of vessel carcinoma embolus (31.35% 17.1%) and advanced GC (T ) (81.25% 65.32%) were higher in CEA-high group than CEA-low group. The CEA-positive patients had a significantly poorer prognosis than the CEA-nagetive patients in terms of overall survival (57.74% 90.69%, < 0.05), and no different was found between subgroup of T category, differentiation, nerve invasion, and vessel carcinoma embolus (all > 0.05). Multivariate survival analysis showed that CEA (OR = 4.924), and T category (OR = 2.214) were significant prognostic factors for stage pN GC (all < 0.05). Besides, only T category (OR = 1.962) was an independent hazard factor in the CEA-high group ( < 0.05). Those pretreatment serum CEA levels over 30.02 ng/mL on behalf of worse characteristics and unfavourable tumor behavior, and a poor prognosis for a nearly doubled risk of mortality in GC patients.