Department of Surgery, Kyungpook National University Hospital, Daegu, Korea.
Cancer Res Treat. 2008 Mar;40(1):16-21. doi: 10.4143/crt.2008.40.1.16. Epub 2008 Mar 31.
Carcinoembryonic antigen (CEA) is known to be elevated in nearly all solid malignancies. The prognostic role of CEA in gastric cancers however, is still controversial. We evaluated preoperative serum CEA levels and CEA expression from the resected tumor tissues to determine whether they have prognostic significance in gastric cancer patients.
Medical records of 810 patients who underwent surgery for gastric adenocarcinoma from June, 1998 to February, 2002 in Kyungpook National University Hospital were reviewed. Serum CEA level was evaluated by radioimmunoassay preoperatively, and the cut-off level for positivity was 7.0 ng/ml. Labeled streptavidin-biotin peroxidase method was used to determine CEA expression from the gastric cancer tissues.
Serum and tissue CEA were positive in 9.3% and 91.1% of the patients, respectively. They had no correlation with each other. The positivity rate of serum CEA had positive correlation with invasion depth (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.006), and final stage (p<0.001). Well differentiated tumors showed higher serum CEA positivity (p=0.002). Patients with positive serum CEA had higher recurrence rate (p<0.001). Multivariate analysis showed significantly lower survival rate in patients with preoperative CEA levels over 7 ng/ml than those with lower levels (48.0% vs. 80.7%; p<0.001). The positivity rates of tissue CEA were higher in advanced cancers (p=0.033) and in more advanced stages (p=0.029). Tissue CEA positivity showed no correlation with recurrence or survival.
Preoperative serum CEA level had correlation with disease progression and survival in gastric cancer patients, and proved to be an independent prognostic factor. Tissue CEA expression in gastric cancers had no prognostic information.
癌胚抗原（CEA）已知在几乎所有实体恶性肿瘤中升高。然而，CEA 在胃癌中的预后作用仍存在争议。我们评估了术前血清 CEA 水平和切除肿瘤组织中的 CEA 表达，以确定它们在胃癌患者中的预后意义。
回顾了 1998 年 6 月至 2002 年 2 月在庆北国立大学医院接受胃腺癌手术的 810 名患者的病历。术前通过放射免疫分析评估血清 CEA 水平，阳性截断值为 7.0ng/ml。使用标记链亲和素-生物素过氧化物酶法确定胃癌组织中的 CEA 表达。
血清和组织 CEA 在 9.3%和 91.1%的患者中呈阳性，两者之间无相关性。血清 CEA 的阳性率与浸润深度（p<0.001）、淋巴结转移（p<0.001）、远处转移（p=0.006）和终期（p<0.001）呈正相关。分化良好的肿瘤显示更高的血清 CEA 阳性率（p=0.002）。血清 CEA 阳性的患者复发率更高（p<0.001）。多变量分析显示，术前 CEA 水平超过 7ng/ml 的患者生存率明显低于水平较低的患者（48.0%比 80.7%；p<0.001）。组织 CEA 的阳性率在晚期癌症中较高（p=0.033），在更晚期阶段较高（p=0.029）。组织 CEA 阳性与复发或生存无相关性。
术前血清 CEA 水平与胃癌患者的疾病进展和生存相关，是独立的预后因素。胃癌组织中的 CEA 表达无预后信息。
