Marrelli D, Pinto E, De Stefano A, Farnetani M, Garosi L, Roviello F
Istituto di Scienze Chirurgiche, U.O. Chirurgia Oncologica, University of Siena, 53100, Siena, Italy.
Am J Surg. 2001 Jan;181(1):16-9. doi: 10.1016/s0002-9610(00)00549-3.
The aim of this longitudinal study was to evaluate the effectiveness of the serum tumor markers CEA, CA 19-9, and CA 72-4 in the early diagnosis of recurrence of gastric cancer.
One hundred and thirty-three patients who had undergone potentially curative surgery were considered. Serum samples were obtained preoperatively, 1 week after surgery, and at every follow-up examination. Mean follow-up time for the entire patient population was 41 +/- 33 months, and 71 +/- 27 months for patients classified as disease-free.
Preoperative positivity was 16% for CEA, 35% for CA 19-9, and 20% for CA 72-4. Recurrence of disease was found in 75 patients (56%). Marker sensitivity in recurrent cases was 44% for CEA, 56% for CA 19-9, and 51% for CA 72-4; the combined use of the three markers increased sensitivity to 87%, which reached 100% in patients with positive preoperative levels. Marker specificity, evaluated in 58 disease-free patients, was 79% for CEA, 74% for CA 19-9, and 97% for CA 72-4.
The combined assay of CEA, CA 19-9, and CA 72-4 may be useful for early diagnosis of recurrence of gastric cancer; however, only CA 72-4 positivity should be considered a specific predictor of tumor recurrence.
本纵向研究的目的是评估血清肿瘤标志物癌胚抗原（CEA）、糖类抗原19-9（CA 19-9）和糖类抗原72-4（CA 72-4）在胃癌复发早期诊断中的有效性。
研究纳入了133例接受了根治性手术的患者。术前、术后1周以及每次随访检查时采集血清样本。全体患者的平均随访时间为41±33个月，无病患者的平均随访时间为71±27个月。
术前CEA阳性率为16%，CA 19-9为35%，CA 72-4为20%。75例患者（56%）出现疾病复发。复发病例中，CEA的标志物敏感性为44%，CA 19-9为56%，CA 72-4为51%；三种标志物联合使用可将敏感性提高至87%，术前水平阳性的患者中该敏感性达到100%。在58例无病患者中评估的标志物特异性，CEA为79%，CA 19-9为74%，CA 72-4为97%。
CEA、CA 19-9和CA 72-4联合检测可能有助于胃癌复发的早期诊断；然而，只有CA 72-4阳性应被视为肿瘤复发的特异性预测指标。
