40 Despite the numerous reports on the usefulness of preoperative and postoperative CEA measurements to predict stage, 23 tumor progression, 24 recurrence 25 or prognosis; 28 there is no agreement as to what kinetics of change is likely to be significant and over what period of time such a change should be maintained for significance. 41 The positivity of CEA in the presence of distant metastasis may be explained with the direct role of CEA by acting like an adhesion molecule in invasion and metastasis so the cancer cells producing CEA have more chance of metastasis. 42 , 43 Peritoneal dissemination is frequent and life threatening form of metastasis and recurrence in patients with gastric cancer.
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