Choi Seok Reyol, Jang Jin Seok, Lee Jong Hun, Roh Myung Hwan, Kim Min Chan, Lee Won Sup, Qureshi Waqar
Department of Internal Medicine, Dong-A University College of Medicine, 3-1, Dongdaesin-dong, Seo-gu, Busan, 602-715, Korea.
Dig Dis Sci. 2006 Nov;51(11):2081-6. doi: 10.1007/s10620-006-9166-5. Epub 2006 Sep 29.
It has been suggested that the serum tumor markers AFP, CEA, and CA19-9 may serve as prognostic factors or indicators for recurrence after radical gastrectomy for gastric cancer. We compared the value of these markers in a group with (n=52) and a group without recurrent gastric cancer (n=52) according to the site of recurrence. Serum levels of tumor markers were measured at the time of preoperative diagnosis and at follow-up. At least one tumor marker was positive preoperatively in 20 with recurrence vs. 7 controls (p=0.007). The peritoneum was the most common recurrent site. The positive predictive value of AFP was high at the time of diagnosis and CA19-9 positivity was high at the time of recurrence. Positive CEA suggested recurrence to the liver. In summary, an elevated tumor marker at diagnosis or during follow up may identify patients at higher risk for a recurrence. CA19-9 may be especially useful as a marker for peritoneal recurrence of the gastric cancer, and CEA for recurrence to liver.
有人提出，血清肿瘤标志物甲胎蛋白（AFP）、癌胚抗原（CEA）和糖类抗原19-9（CA19-9）可作为胃癌根治术后复发的预后因素或指标。我们根据复发部位，对一组有复发性胃癌的患者（n=52）和一组无复发性胃癌的患者（n=52）的这些标志物的值进行了比较。在术前诊断时和随访时测量血清肿瘤标志物水平。术前至少有一种肿瘤标志物呈阳性的复发患者有20例，而对照组有7例（p=0.007）。腹膜是最常见的复发部位。诊断时AFP的阳性预测值较高，复发时CA19-9阳性率较高。CEA阳性提示复发至肝脏。总之，诊断时或随访期间肿瘤标志物升高可能提示患者复发风险较高。CA19-9作为胃癌腹膜复发的标志物可能特别有用，而CEA作为复发至肝脏的标志物。
