Ohtsuka Takao, Sato Seiji, Kitajima Yoshihiko, Tanaka Masayuki, Nakafusa Yuji, Miyazaki Kohji
Department of Surgery, Saga University Faculty of Medicine, Saga, Japan.
Dig Dis Sci. 2008 Jan;53(1):73-9. doi: 10.1007/s10620-007-9825-1. Epub 2007 May 3.
The objective of this study was to assess the frequency and characteristics of false-positive results for tumor markers after curative gastrectomy for gastric cancer. Carcinoembryonic antigen and/or carbohydrate antigen 19-9 were periodically assessed for 168 patients who underwent curative gastrectomy. Cancer recurrence was observed for 17 (10.1%) patients and 151 (89.9%) were disease-free during the mean follow-up period of 23.1 months after the operation. The frequency of false-positive findings for tumor markers after gastrectomy was 14.3% (24/168) for all followed-up patients. Three different patterns of marker elevation were observed in the false-positive group. A false-positive finding for these markers was observed for patients with early-stage cancer and for those with chronic benign diseases, for example bronchitis, liver dysfunction, diabetes mellitus, and renal dysfunction. For most patients with false-positive findings for a marker a spontaneous decrease in the tumor marker was observed 1-2 months after the marker was first observed at a high level after the operation. Surgeons and oncologists should therefore keep in mind the high frequency of false-positive findings for tumor markers after curative gastrectomy for gastric cancer.
本研究的目的是评估胃癌根治性胃切除术后肿瘤标志物假阳性结果的频率及特征。对168例行根治性胃切除术的患者定期检测癌胚抗原和/或糖类抗原19-9。在术后平均23.1个月的随访期内，17例（10.1%）患者出现癌症复发，151例（89.9%）患者无疾病复发。在所有随访患者中，胃切除术后肿瘤标志物假阳性结果的频率为14.3%（24/168）。在假阳性组中观察到三种不同的标志物升高模式。早期癌症患者以及患有慢性良性疾病（如支气管炎、肝功能不全、糖尿病和肾功能不全）的患者出现了这些标志物的假阳性结果。对于大多数标志物出现假阳性结果的患者，在术后首次观察到标志物处于高水平后的1-2个月，肿瘤标志物出现了自发下降。因此，外科医生和肿瘤学家应牢记胃癌根治性胃切除术后肿瘤标志物假阳性结果的高频率。
