Impact of Various Tumor Markers in Prognosis of GastricCancer. A Hospital Based Study from Tertiary Care Hospitalof Kathmandu Valley

Background: To obtain the maximum additional information about the prognosis of gastric cancer, wecompared CA-50 with other previously defined markers. Materials and
Methods: This hospital based studywas carried out in the Department of Biochemistry of Nepalese Army Institute of Health Sciences between 1stJuly 2012 and 31st December 2012. The variables collected were age, gender, AFP, CEA, CA19-9, and CA50,assayed with ELISA reader for all cases. The cut off values for serum AFP, CEA, CA19-9, and CA-50 were 10μg/l, 10 μg/l, 37 U/ml, and 20 U/ml, respectively according to the manufacturer’s instructions. Approval for thestudy was obtained from the institutional research ethical committee.
Results: Of the 40 examined patients, 13patients had tumors located in the upper third of the stomach, 6 patients had tumors in the middle third, 16patients had tumors in the lower third, and 5 patients had tumors occupying two-thirds of the stomach or more.The distribution of lymph node staging of the patients was as follows: 7 patients belonged to N0, 9 patients to N1stage, 10 patients to N2 stage, and 14 patients to N3 stage. The statistical method of Cox proportional hazardsusing multivariate analysis also illustrated that tumor markers including CEA (2.802), CA19-9 (2.690), CA50(2.101), were independent prognostic factors, as tumor size (1.603), and lymph node stage (1.614).
Conclusions:The tumour markers now available, like CEA, CA 19-9 and CA 50, chiefly perceive advanced gastric cancer.The preoperative rise in those tumour marker level have a prognostic significance and may be clinically helpfulin choosing patients for adjuvant management.