Preoperative CEA With Different Levels On The Prognosis Of Gastric Cancer Patients

Objective: Gastric cancer is a malignant tumor with high morbidity and mortality.This study aims to elucidate the relevant factors affecting the prognosis of gastric cancer by analyzing the clinicopathologic data and survival conditions of patients with gastric cancer.This study futher analyzes the effect of different levels of preoperative CEA on the prognosis of gastric cancer patients.Methods: We collected the complete clinicopathologic data and postoperative survival conditions of 144 patients with gastric cancer who had undergone surgery in Affiliated Hospital of Guilin Medical College from June 2009 to December 2012.we analyzed the relevant factors that may affect the prognosis of patients,and We further studied the effect of factors that affect the prognosis of gastric cancer on the overall survival rate of postoperative patients.We used the receiver operating characteristic curve to determine the best cut-off value of CEA,which was finally determined to be 1.16 ng / ml,and the follow-up patients were divided into low CEA group(CEA?1.16)and high CEA group(CEA> 1.16).Then we compared the overall survival of the two groups.Using the propensity score matching method to balance the intergroup variables,we compared the effect of different levels of CEA on postoperative survival again.Results: The 1-year survival rate,3-year survival rate and 5-year survival rate of the 144 gastric cancer patients were 79.17%,59.03% and 47.22% respectively.Univariate analysis showed that CEA(P<0.001),CA19-9(P<0.001),tumor diameter(P<0.001),tumor differentiation(P=0.021),T stage(P=0.001),N stage(P=0.003),M stage(P<0.001)and postoperative chemotherapy(P=0.008)were important factors affecting the prognosis of postoperative gastric cancer patients.Multivariate analysis showed that CEA(P=0.003),tumor diameter(P=0.013),tumor differentiation(P=0.007),T stage(P=0.049),M stage(P=0.045)and postoperative chemotherapy(P=0.001)were independent factors affecting the prognosis of postoperative gastric cancer patients.Overall survival rates of patients with low CEA(CEA?1.16ng/ml)before and after propensity score matching were significantly higher than those with high CEA(CEA>1.16ng/ml).Conclusions: CEA,tumor diameter,tumor differentiation degree,T stage,M stage and postoperative chemotherapy were independent factors affecting the prognosis of postoperative gastric cancer patients.The prognosis of patients with low CEA(CEA?1.16ng/ml)was significantly better than that of patients with high CEA(CEA>1.16ng/ml).This result suggests that CEA=1.16ng/ml may be a critical value for evaluating the prognosis of gastric cancer.