Ychou M, Tuszinski T, Pignon J P, Bidart J M, Bellet D, Bohuon C, Rougier P
Service de Gastroentérologie, Institut Gustave-Roussy, Villejuif.
Gastroenterol Clin Biol. 1992;16(11):848-52.
The aim of this study was to compare carcinoembryonic antigen (CEA) and CA19-9 for the detection of local recurrences and distant metastases after complete resection of gastric carcinoma. At least one postoperative measurement of CEA and CA19-9 was performed in 54 patients. Among these, 32 had recurrence (59%) with a median follow-up of 618 days. Significantly higher sensitivity was observed for CA19-9 in comparison with CEA (68.8% vs 38.2% respectively), but specificity was slightly lower (81.8% vs 95.6% respectively). Increased CEA plasma level never preceded the diagnosis of recurrence while increasing CA19-9 preceded diagnosis in 13 patients (40.6%) from 1 to 22 months (median = 4.5 months). Increasing the normal range of CA19-9 to 80 UI/mL (2.5 x N) raises the specificity to 100% with acceptable sensitivity (53.1%). This study shows that CA19-9, compare with CEA, allows diagnosis of recurrence more often and earlier in the follow-up of resected gastric cancer.
本研究的目的是比较癌胚抗原(CEA)和CA19-9在胃癌根治性切除术后检测局部复发和远处转移的情况。对54例患者进行了至少一次术后CEA和CA19-9检测。其中32例复发(59%),中位随访时间为618天。与CEA相比,CA19-9的敏感性显著更高(分别为68.8%和38.2%),但特异性略低(分别为81.8%和95.6%)。CEA血浆水平升高从未先于复发诊断,而CA19-9升高在13例患者(40.6%)中先于诊断,时间为1至22个月(中位时间 = 4.5个月)。将CA19-9的正常范围提高到80 UI/mL(2.5×N)可使特异性提高到100%,敏感性尚可(53.1%)。本研究表明,与CEA相比,CA19-9在胃癌切除术后随访中能更频繁、更早地诊断复发。