# Serum CEA, CA19-9, and AFP as biomarkers for gastric cancer

## TL;DR

This study examines the use of CEA, CA19-9, and AFP as biomarkers for gastric cancer, finding that their combined use improves diagnostic accuracy and that high CEA and CA19-9 levels are linked to worse outcomes.

## Contribution

The study evaluates the combined diagnostic value and prognostic significance of CEA, CA19-9, and AFP in gastric cancer patients.

## Key findings

- Combined use of CEA, CA19-9, and AFP improves diagnostic accuracy for gastric cancer.
- High CEA levels and CA19-9 are associated with lymph node metastasis and poorer prognosis.
- AFP showed no meaningful association with disease characteristics.

## Abstract

The diagnostic value of AFP CA19-9 and CEA as biomarkers in gastric carcinoma remains uncertain. This research explores their role in forecasting patient survival and disease progression.

A total of 630 early-stage gastric cancer patients who underwent gastrectomy between January 2018 and June 2024 were analysed. Pathological evaluations were conducted, and serum concentrations of CEA, CA19-9, and AFP were measured. Statistical methods were employed to evaluate the relationship between these markers, tumour characteristics, and their impact on prognosis.

The mean age of patients was 59 years. The 1-year and 5-year survival rates were 98.3% and 91.4%, respectively. The positivity rates for CEA, CA19-9, and AFP were 5.1%, 6.2%, and 2.3%, respectively, resulting in an overall detection rate of 12.4%. The mean serum concentration of CEA was 4.8 ng/mL, the median concentration of CA19-9 was 45.2 U/mL, and the concentration range of AFP was from 3.5 ng/mL to 12.7 ng/mL. Elevated levels of CEA and CA19-9 were associated with metastasis of lymph nodes and higher tumour stages, while AFP showed no meaningful association with disease characteristics. Multivariate analysis identified age over 65, lymph node metastasis, and high CEA levels as independent risk factors for poorer outcomes in gastric cancer.

Although CEA, CA19-9, and AFP individually show low detection rates in gastric cancer, their combined use improves diagnostic accuracy. Elevated CA19-9 is associated with lymph node metastasis, and high CEA independently indicates a poorer prognosis. Additional research is necessary to clarify the clinical utility of these biomarkers in early detection and prognostic evaluation.