Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
J Gastric Cancer. 2014 Dec;14(4):221-8. doi: 10.5230/jgc.2014.14.4.221. Epub 2014 Dec 26.
This study aimed to evaluate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels to detect gastric cancer recurrence.
We retrospectively reviewed 154 patients who developed recurrence within 2 years after curative gastric cancer surgery and analyzed the relationship between postoperative CEA and CA19-9 levels and recurrence. We readjusted the cut-off values to improve the detection of recurrence. Subgroup analysis according to clinicopathologic variables was performed to further investigate the relationship between recurrence and CEA and CA19-9 levels.
The sensitivity and specificity for elevated CEA levels to detect recurrence were 40.6% and 89.5%, respectively, and those for CA19-9 were 34.2% and 93.6%, respectively. The sensitivity and specificity for elevation of either tumor marker were 54.3% and 84.0%, respectively; those for elevation of both tumor markers were 19.2% and 98.4%, respectively. By readjusting the cut-off values from 5.0 ng/ml to 5.2 ng/ml for CEA and from 37.00 U/ml to 30.0 U/ml for CA19-9, the sensitivity was increased from 34.2% to 40.2% for CA19-9, while there was no increase in sensitivity for CEA. In subgroup analysis, the sensitivity of CEA was higher in patients with elevated preoperative CEA levels than in patients with normal preoperative CEA levels (86.7% versus 33.7%; P<0.001). Furthermore, the sensitivity of CA19-9 was higher in patients with elevated preoperative CA19-9 levels than in patients with normal preoperative CA19-9 levels (82.61% versus 26.83%; P<0.001).
CEA and/or CA19-9 measurement with the readjusted cut-off values allows for more effective detection of gastric cancer recurrence.
本研究旨在评估血清癌胚抗原（CEA）和糖类抗原 19-9（CA19-9）水平对胃癌复发的检测价值。
我们回顾性分析了 154 例根治性胃癌手术后 2 年内复发的患者，并分析了术后 CEA 和 CA19-9 水平与复发的关系。我们重新调整了截断值以提高对复发的检测。根据临床病理变量进行亚组分析，进一步探讨 CEA 和 CA19-9 水平与复发的关系。
CEA 水平升高对复发的敏感性和特异性分别为 40.6%和 89.5%，CA19-9 分别为 34.2%和 93.6%。任一肿瘤标志物升高的敏感性和特异性分别为 54.3%和 84.0%；两种肿瘤标志物均升高的敏感性和特异性分别为 19.2%和 98.4%。通过将 CEA 的截断值从 5.0ng/ml 调整至 5.2ng/ml，CA19-9 的截断值从 37.00U/ml 调整至 30.0U/ml，CA19-9 的敏感性从 34.2%增加到 40.2%，而 CEA 的敏感性没有增加。在亚组分析中，术前 CEA 水平升高患者的 CEA 敏感性高于术前 CEA 水平正常患者（86.7%比 33.7%；P<0.001）。此外，术前 CA19-9 水平升高患者的 CA19-9 敏感性高于术前 CA19-9 水平正常患者（82.61%比 26.83%；P<0.001）。
调整后的截断值检测 CEA 和/或 CA19-9 可更有效地检测胃癌复发。
