Objective   To investigate the predictive value of preoperative and postoperative serum tumor markers, namely, carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4, in the diagnosis of gastric cancer recurrence at different stages.

  Methods   Analysis was performed in 564 patients who underwent curative resection for gastric cancer between January 2002 and March 2007, received no chemotherapy at our hospital, and received complete follow-up according to the schedule determined prospectively. The values of CEA, CA19-9, and CA72-4 were evaluated before and after surgery.

  Results   In the pTNM-Ⅰ and pTNM-Ⅱ stage groups, patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels showed recurrence rates of 50.0%, 24.1%, and 22.6%, respectively. Similarly, the recurrence rates of patients with positive postoperative serum CEA, CA72-4, and CA19-9 levels were 42.9%, 21.7%, and 14.3%, respectively. Multivariate analysis showed that the positive preoperative serum CEA level could be an independent factor of recurrence. In the pTNM-Ⅲ stage group, the recurrence rates of patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels were 50.0%, 55.2%, and 47.6%, respectively. The recurrence rates of patients with positive postoperative serum CEA, CA19-9, and CA72-4 levels were 75.0%, 66.7%, and 66.7%, respectively. Multivariate analysis showed that high postoperative serum CA72-4 levels could be an independent factor of gastric cancer recurrence.

  Conclusion   Serum tumor markers exhibited different predictive values in different pTNM stages. Preoperative CEA level could be used to predict recurrence in patients with pTNM-Ⅰ and pTNM-Ⅱ stages of gastric cancer. Moreover, postoperative CA72-4 level could be used to predict recurrence in patients with pTNM-Ⅲ stage gastric cancer.