单一肿瘤标志物对胃癌患者预后的影响并不理想。本研究探讨了一种新的胃癌患者预后评估方法，使用三种重要的肿瘤标志物(CEA、CA72-4和CA19-9)的组合。纳入了1966例在中国广州中山大学肿瘤医院进行根治性胃切除手术的胃癌患者的数据。通过Cox回归分析，分析所有因素对总生存率(OS)的危险比(Hazard Ratio)。使用等高线图和校准曲线建立生存预测模型。预测准确性通过一致性指数(C-index)进行评估。 所有患者根据升高的肿瘤标志物数量分为四组(C0-C3)。术前C0-C3组的5年总生存率分别为83.8%(81.3-86.4%)、72.8%(68.5-77.4%)、58.9%(50.4-68.9%)和18.5%(4.0-33.0%)，术后C0-C3组的分别为82.1%(79.4-84.8%)、76.1%(72.2-80.3%)、57.6%(48.4-68.5%)和16.8%(5.1-28.5%)，在术前和术后队列中各C0-C3亚组之间存在显著差异。多变量分析显示，术前升高的肿瘤标志物(HR: 6.001，95% CI: 3.523-10.221)和术后升高的肿瘤标志物(HR: 8.149，95% CI: 4.962-13.528) 是胃癌患者的独立风险因素。使用肿瘤标志物的组合的C-index为0.65-0.66，高于单一肿瘤标志物的C-index(0.53-0.56)。 与单一肿瘤标志物相比，使用肿瘤标志物的组合显著改善了预后价值。包括组合肿瘤标志物的生存预测模型准确有效。© 2023年。外科肿瘤学学会。

The effect of a single tumor marker on the prognosis of gastric cancer patients is not ideal. This study explored a novel prognostic assessment method for gastric cancer (GC) patients using a combination of three important tumor markers (CEA, CA72-4, and CA19-9).Data from 1966 GC patients who underwent curative gastrectomy at Sun Yat-Sen University Cancer Center (Guangzhou, China) were included. Hazard ratios (HR) for all factors for overall survival (OS) were analyzed by Cox regression. A nomogram and calibration curve were used to establish the survival prediction model. The prediction accuracy was evaluated with the concordance index (C-index).All patients were divided into four groups (C0-C3) according to the number of elevated tumor markers. The 5-year OS rates of the patients in preoperative groups C0-C3 were 83.8% (81.3-86.4%), 72.8% (68.5-77.4%), 58.9% (50.4-68.9%), and 18.5% (4.0-33.0%), respectively, and those in postoperative groups C0-C3 were 82.1% (79.4-84.8%), 76.1% (72.2-80.3%), 57.6% (48.4-68.5%), and 16.8% (5.1-28.5%), respectively, with significant differences between each C0-C3 subgroup in both preoperative and postoperative cohorts. Multivariate analysis showed that preoperative (HR: 6.001, 95% CI: 3.523-10.221) and postoperative (HR: 8.149, 95% CI: 4.962-13.528) elevated tumor markers were independent risk factors for GC patients. The C-index for the combined use of tumor markers was 0.65-0.66, which was higher than that for using a single tumor marker (0.53-0.56).The combined use of tumor markers significantly improved the prognostic value compared with using a single tumor marker. The survival prediction model including the combined tumor markers was accurate and effective.© 2023. Society of Surgical Oncology.