Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2004 Jun;36(3):178-81. doi: 10.4143/crt.2004.36.3.178. Epub 2004 Jun 30.
Peritoneal metastasis is a crucial factor for the prognosis in gastric cancer, but its diagnosis is difficult before laparotomy. This study analyzed the usefulness of diagnostic imaging and various tumor markers in the detection of peritoneal metastasis in gastric cancer.
The sera from 768 patients with gastric cancer were measured for CEA, CA19-9 and CA125 levels using a commercial immunoradiometric assay. All the patients underwent diagnostic imaging with computed tomography (CT) and ultrasound (US) before laparotomy.
Preoperative levels of CEA, CA19-9 and CA125 were above the cut-off levels in 15.4%, 8.7% and 5.7% of all cases, respectively. Eighty-eight patients were diagnosed with peritoneal metastasis by laparotomy. CT and US revealed peritoneal dissemination in 15 of 88 patients (17%). Among the three tumor markers, CA19-9 and CA125 showed similar detection rates of peritoneal metastasis (37.5% and 38.6%, respectively). In particular, the serum CA125 levels showed the best sensitivity (38.6%), specificity (98.4%), and diagnostic accuracy (91.5%), and the highest odd ratio (24.46, 95% CI: 11.17 approximately 53.57) for predicting peritoneal metastasis among the markers tested. CEA did not add significant predictive information (p=0.471).
Preoperative serum CA19-9 and CA125 levels may provide a predictable value in determining peritoneal metastasis in patients with gastric cancer.
腹膜转移是胃癌预后的关键因素，但在剖腹手术前很难诊断。本研究分析了诊断成像和各种肿瘤标志物在胃癌腹膜转移检测中的作用。
采用商业免疫放射分析试剂盒检测 768 例胃癌患者血清中 CEA、CA19-9 和 CA125 水平。所有患者均在剖腹手术前接受计算机断层扫描（CT）和超声（US）诊断成像。
术前 CEA、CA19-9 和 CA125 水平分别高于所有病例的截止值 15.4%、8.7%和 5.7%。88 例患者通过剖腹术诊断为腹膜转移。CT 和 US 显示 88 例患者中有 15 例（17%）存在腹膜播散。在三种肿瘤标志物中，CA19-9 和 CA125 对腹膜转移的检测率相似（分别为 37.5%和 38.6%）。特别是血清 CA125 水平对预测腹膜转移具有最佳的敏感性（38.6%）、特异性（98.4%）和诊断准确性（91.5%），以及最高的优势比（24.46，95%CI：11.17~53.57）。CEA 没有增加显著的预测信息（p=0.471）。
术前血清 CA19-9 和 CA125 水平可能为预测胃癌患者腹膜转移提供有价值的信息。
