T4a 期胃癌肿瘤标志物的预后意义。
Prognostic significance of tumor markers in T4a gastric cancer.
机构信息
Department of Abdominal Surgery, Cancer Hospital, Fudan University, 270 Dong An Road, Shanghai, 200032, People's Republic of China.
出版信息
World J Surg Oncol. 2012 Apr 27;10:68. doi: 10.1186/1477-7819-10-68.
BACKGROUND
The clinical importance of preoperative tumor markers remain elusive in gastric cancer. The aim of this study was to evaluate the prognostic value of AFP, CEA, CA19-9, and CA50 in T4a stage gastric cancer.
METHODS
Two hundred and seventy-three T4a gastric cancer patients who underwent curative D2 gastrectomy between 1996 and 2005 were evaluated. The correlation between tumor markers and clinicopathologic characteristics and prognostic value of preoperative tumor markers were investigated.
RESULTS
Correlation analysis showed that AFP was associated with Borrmann type (P = 0.010); CEA with sex (P = 0.029), tumors site (P = 0.014), and N stage (P = 0.001); CA19-9 with age (P = 0.047), tumor site (P = 0.011), lymphovascular invasion (P = 0.004), and N stage (P = 0.000); CA50 with age (P = 0.017), tumor site (P = 0.004), tumor size (P = 0.014), and N stage (P = 0.000). Multivariate analysis showed that the positivity of preoperative CEA, CA19-9, and CA50 were major independent poor prognostic factors of patients with T4a stage gastric cancer.
CONCLUSIONS
Preoperative serum tumor marker might be a candidate for the staging system in addition to conventional factors.
背景
术前肿瘤标志物在胃癌中的临床重要性仍不明确。本研究旨在评估 AFP、CEA、CA19-9 和 CA50 在 T4a 期胃癌中的预后价值。
方法
评估了 1996 年至 2005 年间接受根治性 D2 胃切除术的 273 例 T4a 期胃癌患者。分析了肿瘤标志物与临床病理特征的相关性及术前肿瘤标志物的预后价值。
结果
相关性分析显示，AFP 与 Borrmann 分型相关（P=0.010）；CEA 与性别（P=0.029）、肿瘤部位（P=0.014）和 N 分期（P=0.001）相关；CA19-9 与年龄（P=0.047）、肿瘤部位（P=0.011）、血管淋巴管侵犯（P=0.004）和 N 分期（P=0.000）相关；CA50 与年龄（P=0.017）、肿瘤部位（P=0.004）、肿瘤大小（P=0.014）和 N 分期（P=0.000）相关。多因素分析显示，术前 CEA、CA19-9 和 CA50 的阳性表达是 T4a 期胃癌患者的主要独立预后不良因素。
结论
术前血清肿瘤标志物可能是除传统因素之外的另一个分期系统候选标志物。
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