Research Papers:

Prognostic values of normal preoperative serum cancer markers for gastric cancer

Fan Feng, Li Sun, Zhen Liu, Shushang Liu, Gaozan Zheng, Guanghui Xu, Man Guo, Xiao Lian, Daiming Fan and Hongwei Zhang _

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Oncotarget. 2016; 7:58459-58469. https://doi.org/10.18632/oncotarget.11248

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Fan Feng1,*, Li Sun1,*, Zhen Liu1,*, Shushang Liu1, Gaozan Zheng1, Guanghui Xu1, Man Guo1, Xiao Lian1, Daiming Fan1, Hongwei Zhang1

1Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 710032, Xi’an, Shaanxi, China

*These authors have contributed equally to this work

Correspondence to:

Hongwei Zhang, email: [email protected]

Keywords: gastric cancer, CA19-9, AFP, CA125, prognosis

Received: May 29, 2016    Accepted: July 28, 2016    Published: August 12, 2016


We examined the prognostic value of normal levels of four serum cancer markers, carcinoembryonic antigen (CEA), carbohydrate associated antigen (CA19-9), alpha-fetoprotein (AFP) and cancer antigen 125 (CA125), in gastric cancer patients. Among 1927 gastric cancer patients enrolled in this study, 1477 were male (76.6%) and 450 were female (23.4%). The median age was 57 years (range 20-86). Clinicopathological features and survival times were recorded, and the association between CEA, CA19-9, AFP, and CA125 levels and patient prognosis was analyzed. The optimal cut-off values were 0.71 for CEA (P=0.317), 9.22 for CA19-9 (P=0.009), 3.76 for AFP (P=0.008) and 15.65 for CA125 (P=0.006). Serum CA19-9 levels correlated with gender, age, and tumor depth (all P<0.05); AFP levels correlated with pathological type (P=0.005); and CA125 levels correlated with gender, tumor size, pathological type, tumor depth and lymph node metastasis (all P<0.05). Relatively high levels of CA19-9, AFP and CA125, still within the normal range, were all associated with poor prognosis (5-year overall survival: 70.6% vs 64.2%, P<0.001. 69.6% vs 54.5%, P=0.011. 70.2% vs 54.9%, P<0.001). However, only CA19-9 and AFP levels were independent prognostic predictors. We conclude that the combined assessment of CA19-9, AFP and CA125 levels could have prognostic value in gastric cancer (P<0.001).

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