Background: We recently found an elevation in the pre-operative peritoneal lavage carcinoembryonic antigen (CEA) level to be associated with an earlier detection of recurrent peritoneal dissemination and a poor prognosis. Method: Two hundred and twenty-nine patients with gastric cancer were intraoperatively measured for tumor markers, CEA and CA125 based on peritoneal lavage using a chemiluminescent enzyme immunoassay. Results: The patients were divided into four groups. (A) The peritoneal lavage CEA (-) CA125 (-) group (CEA < 0.4 ng/ml, CA125 < 200 ng/ml, n = 129); (B) the peritoneal lavage CEA (-) CA125 (+) group (CEA < 0.4 ng/ml, CA125 ≧ 200 ng/ml, n = 50); (C) the peritoneal lavage CEA (+) CA125 (-) group (CEA ≧ 0.4 ng/ml, CA125 < 200 ng/ml, n = 18); and (D) the peritoneal lavage CEA (+) CA125 (+) group (CEA ≧ 0.4 ng/ml, CA125 ≧ 200 ng/ml, n = 32). The 5-year survival of the patients in groups C and D was 40 and 26%, respectively, which was lower than that of the patients in any other group (group A, B; p < 0.0001). Recurrent sites were both peritoneal dissemination and lymph node/liver in group C, while those were only peritoneal dissemination in group D. Conclusion: This combined analysis of these markers is therefore considered to be helpful method to accurately estimate the recurrent sites and prognosis for advanced gastric cancer patients.
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