Hepatogastroenterology

Abstract

BACKGROUND/AIMS: To explore the predictive value of markers in detection of recurrence after resection. METHODOLOGY: This study was a case-control retrospective analysis; 521 patients underwent radical gastrectomy from April 2000 to January 2008, among whom 142 cases with complete data were involved. Seventy one were confirmed with recurrence, while the other 71 without recurrence were randomly selected from the database as control. We analyzed the popular serum marker change patterns and their correlation with imaging. RESULTS: The two groups were well balanced in characteristics. Among the 3 markers, CA72.4 appeared highest in sensitivity (35.2%) while CEA had the lowest sensitivity. The sensitivity of triple-marker was 62.0%. We found that CEA, CA19-9 and CA72.4 elevated 2-4 months before imaging demonstration. If the cut-off values of CEA and CA19-9 were set twice as the upper limit of the normal, the specificities will increase to 98.6% and 94.4%, respectively. The sensitivity of single marker (CEA or CA 2.4) was 33.3% in predicting peritoneal metastasis, triple-marker had the highest sensitivity (66.7%). CONCLUSIONS: The combined of CEA, CA19-9 and CA72.4 had 62.0% sensitivity in the diagnosis of recurrence after radical surgery. Patients whose tumor markers continue to increase should be highly suspected for relapse.