正常癌胚抗原水平提示胃癌患者围手术期化疗获益。
Normal carcinoembryonic antigen indicates benefit from perioperative chemotherapy to gastric carcinoma patients.
机构信息
State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China.
出版信息
World J Gastroenterol. 2012 Aug 7;18(29):3910-6. doi: 10.3748/wjg.v18.i29.3910.
AIM
To evaluate pretreatment serum carcinoembryonic antigen (CEA) as a predictor of survival for patients with locally advanced gastric cancer receiving perioperative chemotherapy.
METHODS
We retrospectively studied a cohort of 228 gastric cancer patients who underwent D2 gastrectomy combined with chemotherapy at the Sun Yat-sen University Cancer Center between January 2005 and December 2009. Among them, 168 patients received 6-12 cycles of oxaliplatin-based adjuvant (post-operative) chemotherapy, while 60 received perioperative chemotherapy (2 cycles of FOLFOX6 or XELOX before surgery and 4-10 cycles after surgery). Serum CEA was measured using an enzyme immunoassay. The follow-up lasted until December 2010.
RESULTS
In the group that had elevated serum CEA, the difference in survival time between patients receiving perioperative chemotherapy and those receiving adjuvant chemotherapy had no statistical significance (P > 0.05). However, in the group that had normal serum CEA, patients receiving perioperative chemotherapy had a longer survival time. In multivariate analysis, T staging and lymph node metastatic rate were independent prognostic factors for the patients. Perioperative chemotherapy improved the overall survival of patients who had a normal pretreatment CEA level (P = 0.070).
CONCLUSION
Normal pretreatment serum CEA is a predictor of survival for patients receiving perioperative chemotherapy.
目的
评估术前血清癌胚抗原（CEA）作为接受围手术期化疗的局部晚期胃癌患者生存的预测指标。
方法
我们回顾性研究了中山大学肿瘤中心 2005 年 1 月至 2009 年 12 月期间接受 D2 胃切除术联合化疗的 228 例胃癌患者队列。其中，168 例患者接受了 6-12 周期奥沙利铂为基础的辅助（术后）化疗，60 例患者接受了围手术期化疗（手术前 2 周期 FOLFOX6 或 XELOX，手术后 4-10 周期）。使用酶联免疫吸附试验测量血清 CEA。随访时间截至 2010 年 12 月。
结果
在血清 CEA 升高的组中，接受围手术期化疗和接受辅助化疗的患者生存时间差异无统计学意义（P > 0.05）。然而，在血清 CEA 正常的组中，接受围手术期化疗的患者生存时间更长。多因素分析显示，T 分期和淋巴结转移率是患者的独立预后因素。围手术期化疗改善了术前 CEA 水平正常患者的总生存率（P = 0.070）。
结论
术前血清 CEA 正常是接受围手术期化疗的患者生存的预测指标。
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