术前癌胚抗原（CEA）、糖类抗原19-9（CA 19-9）、糖类抗原72-4（CA 72-4）及甲胎蛋白（AFP）水平在胃癌中的预后价值

Prognostic value of preoperative CEA, CA 19-9, CA 72-4, and AFP levels in gastric cancer.

作者信息

Ucar Edip, Semerci Ersan, Ustun Hasan, Yetim Tugba, Huzmeli Can, Gullu Murat

机构信息

Department of Internal Medicine, Mustafa Kemal University, Hatay, Turkey.

出版信息

Adv Ther. 2008 Oct;25(10):1075-84. doi: 10.1007/s12325-008-0100-4.

DOI:10.1007/s12325-008-0100-4

PMID:18821070

Abstract

INTRODUCTION

Recent research has suggested that serum tumor markers can give valuable prognostic information in gastric cancer. In this study, we examined the relationship between preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 72-4, and alfa fetoprotein (AFP) levels on clinicopathologic significance in gastric cancer patients.

METHODS

Preoperative plasma levels of CEA, CA 19-9, CA 72-4, and AFP were retrospectively examined in 95 patients who underwent surgical resection for gastric cancer, and the prognostic value of the tumour markers were estimated.

RESULTS

The percentage of CA 19-9, CA 72-4, CEA, and AFP-positive cases were 41%, 32.6%, 24.2%, and 8.4%, respectively. CEA was more frequently positive in the patients with liver metastases (P=0.02). CA 19-9 was more frequently positive in patients with lymph node (P=0.005), peritoneal (P=0.01), and serosal (P=0.03) involvement. CA 72-4 was more frequently positive in patients with lymph node (P=0.01), peritoneal (P=0.03), and liver (P=0.01) involvement. Low 3-year cumulative survival was associated significantly with elevated serum levels of CEA (P=0.001), CA 19-9 (P=0.001), CA 72-4 (P=0.001), and AFP (P=0.01). In multivariate analysis, age, tumor stage, and CA 72-4 were the only independent prognostic factors. Being positive for CA 72-4 was associated with a 3.8-fold higher risk of death (95% confidence intervals: 1.3, 10.9).

CONCLUSION

Our results suggest that high preoperative serum levels of CA 72-4 in gastric cancer patients are associated with a higher risk of death due to gastric cancer.

摘要

引言

近期研究表明，血清肿瘤标志物可为胃癌提供有价值的预后信息。在本研究中，我们检测了术前血清癌胚抗原（CEA）、糖类抗原（CA）19-9、CA 72-4和甲胎蛋白（AFP）水平与胃癌患者临床病理意义之间的关系。

方法

回顾性检测了95例行胃癌手术切除患者术前血浆中CEA、CA 19-9、CA 72-4和AFP的水平，并评估了肿瘤标志物的预后价值。

结果

CA 19-9、CA 72-4、CEA和AFP阳性病例的百分比分别为41%、32.6%、24.2%和8.4%。CEA在肝转移患者中更常呈阳性（P=0.02）。CA 19-9在有淋巴结转移（P=0.005）、腹膜转移（P=0.01）和浆膜转移（P=0.03）的患者中更常呈阳性。CA 72-4在有淋巴结转移（P=0.01）、腹膜转移（P=0.03）和肝转移（P=0.01）的患者中更常呈阳性。3年累积生存率低与血清CEA（P=0.001）、CA 19-9（P=0.001）、CA 72-4（P=0.001）和AFP（P=0.01）水平升高显著相关。多因素分析显示，年龄、肿瘤分期和CA 72-4是仅有的独立预后因素。CA 72-4呈阳性与死亡风险高3.8倍相关（95%置信区间：1.3，10.9）。