Abstract
BACKGROUND: Postoperative recurrence remains a major challenge in gastric cancer management. Monitoring serum biomarkers such as carcinoembryonic antigen (CEA) may enable earlier detection of recurrence and improve patient outcomes. AIM: To evaluate postoperative serum CEA expression and its efficacy in predicting gastric cancer recurrence. METHODS: This retrospective study analyzed clinical data from 120 patients with primary gastric cancer treated between January 2022 and January 2023. Patients were categorized into recurrence and non-recurrence groups. Serum levels of CEA, alpha-fetoprotein (AFP), and carbohydrate antigen 19-9 (CA19-9) were measured at one week, three months, and six months postoperatively. Logistic regression identified independent risk factors for recurrence, Pearson correlation assessed the association with recurrence timing, and receiver operating characteristic (ROC) curves evaluated the predictive performance of combined CEA and AFP levels. RESULTS: During 24 months of follow-up, 39 patients (32.50%) experienced recurrence. No significant baseline differences were observed between groups (P > 0.05). CEA, AFP, and CA19-9 levels at one week were comparable between groups (P > 0.05), whereas levels at three and six months were significantly higher in the recurrence group (P < 0.05). Logistic regression identified postoperative CEA and AFP as independent risk factors for recurrence (P < 0.05). Pearson correlation showed a negative association between CEA and AFP levels and recurrence interval (P < 0.05). ROC curve analysis demonstrated that combined CEA and AFP yielded an area under the curve of 0.826, with specificity of 94.36% and sensitivity of 90.50%, outperforming either marker alone (P < 0.05). CONCLUSION: Dynamic postoperative monitoring of serum CEA and AFP enables early prediction and detection of gastric cancer recurrence.