Combined albumin and CEA improve prognostic prediction in resectable gastric cancer

Preoperative high levels of serum carcinoembryonic antigen (CEA) and low levels of albumin (ALB) are closely related to poor prognosis among patients with gastric cancer. This study aims to determine the prognostic value of preoperative serum ALB plus CEA levels as a new biomarker in patients with resectable gastric cancer. This retrospective cohort study included 329 patients with gastric cancer. The optimal cutoff values of ALB and CEA were 4.77 ng/mL and 41.47 g/L, respectively. Patients were stratified into three groups based on these cutoff values: ALB-CEA = 0 (ALB > 41.47 g/L and CEA ≤ 4.77 ng/mL), ALB-CEA = 1 (ALB ≤ 41.47 g/L or CEA > 4.77 ng/mL), and ALB-CEA = 2 (ALB ≤ 41.47 g/L and CEA > 4.77 ng/mL). Kaplan-Meier curve and Cox proportional model were used to determine the predictive effect of the biomarker on the overall survival of patients in the training and validation sets. ALB-CEA had a larger area under the curve than ALB or CEA alone (0.703, 0.671, 0.635 in the validation set; 0.776, 0.694, 0.616 in the validation set respectively). The Kaplan-Meier curve revealed that higher ALB-CEA scores were indicative of lower survival rates (p < 0.001). Additionally, the multivariate analysis revealed that ALB-CEA was an independent risk factor for poor prognosis in patients with gastric cancer (p < 0.05). Preoperative ALB-CEA may be a new biomarker for predicting the prognosis of patients with gastric cancer. For those patients with higher preoperative ALB-CEA scores, more extensive postoperative follow-up should be performed to detect tumor progression early and intervene in time.