Abstract

Introduction: Gastric cancer is one of the most common cancers worldwide. Early gastric cancer is typically small and asymptomatic, and the high mortality from gastric cancer is mainly due to late presentation. Surgical resection of the primary tumor and regional lymph nodes (RLNs) along with adjuvant treatment is the only curative approach. However, overall prognosis remains poor, with 5-year survival rates of only 20%. Many studies have identified high preoperative levels of CEA as a poor prognostic factor for patients with potentially resect able GC. Other published works have suggested that a combination of CEA, CA 19.9 and the relatively new marker CA 72.4 provides additional prognostic information on these patients, with preoperative positivity for one of them considered as evidence of a high recurrence risk even in the early stages. Materials and Methods: This is a prospective observational study which included all the patients who underwent treatment for Gastric carcinoma, in the Department of Surgical Gastroenterology at Nizam's Institute of Medical Sciences, Hyderabad, over a period of 2 years from 1st March 2017 to 30th April 2019. Correlation of the tumour marker values were done with staging, tumor differentiation and lymph node involvement in Gastric cancer subjects. Appropriate analysis were carried out by use of Student‘s ttest, Fishers Exact Test and Chi Square test for categorical data. Results: Out of all the parameters (pre-operative CEA, CA19-9 and CA72-4,) elevated CA19-9 was the most sensitive marker associated with advanced stage and none of above tumour markers correlate with grade of tumour. CA72 -4 is least sensitive marker associated with advanced stage of tumour. Conclusion: Preoperative increased Serum levels of CA 19 -9 is associated with advanced TNM stage of Carcinoma Stomach as compared to CEA and CA 72-4 No significant association could be demonstrated between these tumor markers with grade or histology of malignancy. Increased Serum CA 19-9 is perhaps an independent predictor of advanced stage and poor prognostic factor in patients with Gastric carcinoma. Hence, the patients with increased Serum CA 19-9 is associated with advanced stage and may require neoadjuvant therapy unless there is no contraindication for neoadjuvant therapy. However, long term follow-up studies and survival analysis and further randomized control studies are needed to substantiate this observational study

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