Guadagni F, Roselli M, Amato T, Cosimelli M, Mannella E, Perri P, Abbolito M R, Cavaliere R, Colcher D, Greiner J W
Laboratory of Tumor Immunology and Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
Cancer. 1991 Dec 1;68(11):2443-50. doi: 10.1002/1097-0142(19911201)68:11<2443::aid-cncr2820681120>3.0.co;2-2.
Eighty-two patients diagnosed with gastrointestinal (GI) adenocarcinoma were evaluated before and for 26 months after primary tumor resection for the presence of two serum tumor markers: tumor-associated glycoprotein-72 (TAG-72) and carcinoembryonic antigen (CEA). Elevated TAG-72 and CEA serum levels were found preoperatively in 32 (39%) and 34 (41.5%) of the 82 patients, respectively. The percentage of patients with elevated serum levels of either TAG-72 or CEA was 56.1% (46 of 82). Twelve (15%) patients who had normal CEA serum levels had elevated TAG-72 serum levels, and conversely, serum from 14 (17%) patients who were TAG-72 negative were CEA positive. Forty-five of the 82 patients were diagnosed with advanced disease (i.e., Stages C and D for colorectal, Stages III and IV for stomach), and 29 (64.4%) and 26 (57.8%) of those patients had elevated serum levels of TAG-72 or CEA, respectively. Elevated levels of either TAG-72 or CEA, however, were found in sera of 82.2% of patients with advanced GI cancer, which is an increase of 24.4% over the use of CEA antigen alone as a marker of disease. The measurement of both TAG-72 and CEA may improve the diagnosis of patients with GI malignant disease due to the apparent complementary association which exists between these tumor markers. Serum TAG-72 and CEA levels were monitored in 31 patients for varying lengths of time after resection of the carcinoma; 11 patients developed recurrent disease. Sera from nine of 11 (81.8%) of these patients had elevated TAG-72 levels and six of 11 (54.5%) had elevated CEA levels. Tumor marker elevations were observed either before (35 to 166 days) or at the time of diagnosis of recurrence. The elevation of one or both markers correlated with the clinical status in ten of 11 (90.9%) patients with recurrence. In addition, 20 patients who were clinically free of disease after more than 700 days' follow-up had normal serum levels of both TAG-72 and CEA. These findings suggest that the combined use of serum TAG-72 and CEA measurements may improve detection of recurrence in patients with GI cancer and may be useful in the postsurgical management of GI adenocarcinoma patients.
82例被诊断为胃肠道腺癌的患者在原发性肿瘤切除术前及术后26个月接受了评估，检测两种血清肿瘤标志物：肿瘤相关糖蛋白72（TAG-72）和癌胚抗原（CEA）。82例患者中，术前分别有32例（39%）和34例（41.5%）的TAG-72和CEA血清水平升高。血清中TAG-72或CEA水平升高的患者比例为56.1%（82例中的46例）。12例（15%）CEA血清水平正常的患者TAG-72血清水平升高，相反，14例（17%）TAG-72阴性患者的血清CEA呈阳性。82例患者中有45例被诊断为晚期疾病（即结直肠癌的C期和D期，胃癌的III期和IV期），其中29例（64.4%）和26例（57.8%）患者的TAG-72或CEA血清水平升高。然而，在晚期胃肠道癌患者中，82.2%的患者血清中TAG-72或CEA水平升高，这比单独使用CEA抗原作为疾病标志物增加了24.4%。由于这两种肿瘤标志物之间存在明显的互补关系，同时检测TAG-72和CEA可能会改善胃肠道恶性疾病患者的诊断。对31例患者在癌切除术后不同时间监测血清TAG-72和CEA水平；11例患者出现复发。这11例患者中有9例（81.8%）的血清TAG-72水平升高，11例中有6例（54.5%）的CEA水平升高。在复发诊断前（35至166天）或复发时观察到肿瘤标志物升高。11例复发患者中有10例（90.9%）一种或两种标志物升高与临床状况相关。此外，20例在随访700多天后临床无疾病的患者血清TAG-72和CEA水平均正常。这些发现表明，联合检测血清TAG-72和CEA可能会改善胃肠道癌患者复发的检测，并且可能有助于胃肠道腺癌患者的术后管理。
