Tatsuta M, Iishi H, Yamamura H, Okuda S
Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan.
Oncology. 1988;45(1):30-4. doi: 10.1159/000226526.
The relationship of the level of carcinoembryonic antigen (CEA) in the gastric juice to the extent of intestinal metaplasia and gastric cancer, and clinical values of gastric CEA for identifying high-risk patients for gastric cancer were examined. A significant correlation was found between the levels of gastric CEA and the distribution of intestinal metaplasia. Studies were made by the endoscopic Congo red-methylene blue test developed at our hospital. Gastric CEA levels were significantly higher in patients with localized and diffuse intestinal metaplasia than in those with no intestinal metaplasia. The mean levels of gastric CEA in patients with well-differentiated adenocarcinomas were significantly higher than in those with diffuse intestinal metaplasia. They were also significantly higher in patients with poorly differentiated adenocarcinomas than in patients with no intestinal metaplasia, but not significantly higher than in those with diffuse intestinal metaplasia. Endoscopic follow-up examinations show that gastric cancer was detected in only 1 patient with a gastric CEA level of 10 ng/ml or more, but in none of those with gastric CEA of less than 10 ng/ml, during the average observation period of 4.3 years. These results indicate that gastric CEA is produced both by intestinal metaplasia and well- and poorly differentiated adenocarcinomas, and that gastric CEA is useful in identifying high-risk patients for gastric cancer.
研究了胃液中癌胚抗原（CEA）水平与肠化生程度及胃癌的关系，以及胃CEA在识别胃癌高危患者中的临床价值。发现胃CEA水平与肠化生分布之间存在显著相关性。采用我院研发的内镜刚果红-亚甲蓝试验进行研究。局限性和弥漫性肠化生患者的胃CEA水平显著高于无肠化生患者。高分化腺癌患者的胃CEA平均水平显著高于弥漫性肠化生患者。低分化腺癌患者的胃CEA水平也显著高于无肠化生患者，但与弥漫性肠化生患者相比无显著差异。内镜随访检查显示，在平均4.3年的观察期内，胃CEA水平为10 ng/ml或更高的患者中仅1例检测到胃癌，而胃CEA低于10 ng/ml的患者均未检测到胃癌。这些结果表明，胃CEA由肠化生以及高分化和低分化腺癌产生，且胃CEA有助于识别胃癌高危患者。
