Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2013 May 1;54(3):643-9. doi: 10.3349/ymj.2013.54.3.643.
To investigate the use of pretreatment carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) as prognostic factors to determine survival in pancreatic adenocarcinoma.
A retrospective review of the medical records of patients who were diagnosed with pancreatic adenocarcinoma and received surgery, chemoradiotherapy or chemotherapy was performed. Factors, including CA 19-9 and CEA, associated with the survival of pancreatic cancer patients were analyzed.
Patients with the median age of 65 years were included (n=187). Elevated serum CA 19-9 levels and CEA levels were observed in 75.4% and 39% of patients at diagnosis, respectively. CEA was correlated with tumor stages (p=0.005), but CA 19-9 was not. CA 19-9 and CEA were elevated in 69.0% and 33.3% of patients with resectable pancreatic cancer, and elevated in 72.9% and 47.2% of patients with advanced pancreatic cancer, respectively. The median overall survival of the normal serum CEA group was longer than that of the elevated serum CEA group (16.3 months vs. 10.2 months, p=0.004). However, the median overall survival of the normal serum CA 19-9 group was not different from that of the elevated serum CA 19-9 group (12.4 months vs. 13.5 months, p=0.969). The independent factors associated with overall survival were advanced pancreatic cancer [harzard ratio (HR) 4.33, p=0.001] and elevated serum CEA level (HR 1.52, p=0.032).
Patients with elevated serum CEA level at diagnosis demonstrated poor overall survival. Pretreatment CEA level may predict the prognosis of patients with pancreatic adenocarcinoma.
研究术前糖类抗原（CA）19-9 和癌胚抗原（CEA）作为预测因素对确定胰腺癌患者生存情况的作用。
对诊断为胰腺腺癌并接受手术、放化疗或化疗的患者的病历进行回顾性分析。分析与胰腺癌患者生存相关的 CA 19-9 和 CEA 等因素。
共纳入中位年龄为 65 岁的患者（n=187）。诊断时，分别有 75.4%和 39%的患者血清 CA 19-9 和 CEA 水平升高。CEA 与肿瘤分期相关（p=0.005），但 CA 19-9 与肿瘤分期无关。可切除胰腺癌患者中有 69.0%和 33.3%的患者血清 CA 19-9 和 CEA 升高，晚期胰腺癌患者中分别有 72.9%和 47.2%的患者血清 CA 19-9 和 CEA 升高。正常血清 CEA 组的中位总生存期长于升高的血清 CEA 组（16.3 个月比 10.2 个月，p=0.004）。然而，正常血清 CA 19-9 组的中位总生存期与升高的血清 CA 19-9 组无差异（12.4 个月比 13.5 个月，p=0.969）。与总生存期相关的独立因素为晚期胰腺癌（风险比[HR] 4.33，p=0.001）和升高的血清 CEA 水平（HR 1.52，p=0.032）。
诊断时血清 CEA 水平升高的患者总体生存情况较差。治疗前 CEA 水平可能预测胰腺腺癌患者的预后。
