Clinical Research Papers:

Combined preoperative concentrations of CEA, CA 19-9, and 72-4 for predicting outcomes in patients with gastric cancer after curative resection

Xuechao Liu _, Haibo Qiu, Jianjun Liu, Shangxiang Chen, Dazhi Xu, Wei Li, Youqing Zhan, Yuanfang Li, Yingbo Chen, Zhiwei Zhou and Xiaowei Sun

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Oncotarget. 2016; 7:35446-35453. https://doi.org/10.18632/oncotarget.9060

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Xuechao Liu1,2, Haibo Qiu1,2, Jianjun Liu1,2, Shangxiang Chen1,2, Dazhi Xu1,2, Wei Li1,2, Youqing Zhan1,2, Yuanfang Li1,2, Yingbo Chen1,2, Zhiwei Zhou1,2, Xiaowei Sun1,2

1Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China

2Department of Gastric and Pancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China

Correspondence to:

Xiaowei Sun, e-mail: [email protected]

Keywords: CTM, combination of preoperative tumor markers, prognosis, scoring system, tumor markers

Received: October 11, 2015    Accepted: April 11, 2016    Published: April 27, 2016


In many cancers, prognostic factors are useful for identifying high-risk patients and in individualizing treatment. We sought to determine whether a combination of tumor markers (CTM) would improve prognostic accuracy in patients with gastric cancer (GC). The CTM score, which is derived from serum concentrations of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), and carbohydrate antigen 72-4 (CA 72-4), was tested retrospectively in 1134 patients with GC undergoing curative resection between October 2000 and December 2012. The CTM score was 2 for patients with two or three elevated markers, 1 for those with one elevated marker, and 0 for those no elevated markers. Overall survival (OS) in patients with CTM scores 0, 1, and 2 was 61.8%, 31.4%, and 15.1%, respectively (P<.001). The CTM score independently predicted OS on multivariate analysis (HR, 1.95; 95% CI, 1.73 to 2.21; P<.001). Moreover, the area under the receiver operating characteristics curve of the CTM score (0.67; 95% CI, 0.64 to 0.70) was higher than the values of any individual marker (0.63, 0.57, 0.57; P<.001 for all comparisons). The CTM score independently predicted postoperative survival in GC, and it may have better clinical utility than individual tumor markers for identifying high-risk patients with GC.

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