CEA/CA72-4 levels in peritoneal lavage fluid are predictive factors in patients with gastric carcinoma

  • Manabu Yamamoto
  • Keiji Yoshinaga
  • Ayumi Matsuyama
  • Shinichi Tsutsui
  • Teruyoshi Ishida
Original Paper



Increased levels of tumor marker in intra-operative peritoneal lavage are associated with an earlier detection of recurrent peritoneal dissemination.


Intra-operative peritoneal lavage samples from 193 patients with gastric cancer were obtained to determine the levels of the tumor markers, carcinoembryonic antigen (CEA) and cancer-related antigen 72-4 (CA72-4) using a chemiluminescent enzyme immunoassay.


The peritoneal lavage CEA (CY-CEA), CA72-4 (CY-CA72-4) and serosal invasion were independent factors predicting the peritoneal dissemination including CY(+). The patients were divided into four groups on the basis of peritoneal lavage tumor marker status; group A: CY-CEA (−), CY-CA72-4 (−) group (CEA < 0.5 ng/ml, CA72-4 < 1.3 U/ml); group B: CY-CEA (−), CY-CA72-4 (+) group (CEA < 0.5 ng/ml, CA72-4 ≥ 1.3 U/ml); group C: CY-CEA (+), CY-CA72-4 (−) group (CEA ≥ 0.5 ng/ml, CA72-4 < 1.3 U/ml); and group D: CY-CEA (+), CY-CA72-4 (+) group (CEA ≥ 0.5 ng/ml, CA72-4 ≥ 1.3 U/ml). The 5-year survival among the patients in groups A, B, C and D was 87, 68, 38 and 20 %, respectively (p < 0.0001).


Combined analysis of these markers is therefore considered to be helpful for accurately determining sites of recurrence and the prognosis in advanced gastric cancer patients.


Tumor marker Tumor recurrence Gastric cancer Peritoneal dissemination Prognosis 



Peritoneal lavage cytological positive


Carcinoembryonic antigen


Cancer-related antigen 72-4


Cancer antigen 125


The peritoneal lavage carcinoembryonic antigen


The peritoneal lavage cancer-related antigen 72-4


Conflict of interest

The authors declare no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Manabu Yamamoto
    • 1
    • 2
  • Keiji Yoshinaga
    • 1
  • Ayumi Matsuyama
    • 1
  • Shinichi Tsutsui
    • 1
  • Teruyoshi Ishida
    • 1
  1. 1.Department of SurgeryHiroshima Atomic Bomb Survivors HospitalHiroshimaJapan
  2. 2.Department of Gastroenterological SurgeryNational Kyushu Cancer CenterFukuokaJapan

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