Zhou Yang-Chun, Zhao Hai-Jian, Shen Li-Zong
Division of Gastrointestinal Surgery, Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China E-mail :
Asian Pac J Cancer Prev. 2015;16(7):2685-91. doi: 10.7314/apjcp.2015.16.7.2685.
To evaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable gastric cancer (GC), a total of 1,075 consecutive cases with gastric adenocarcinoma were obtained retrospectively from January 2012 and December 2013 in a single tertiary hospital, and the relationships between serum CEA, CA19-9 and clinicopathologic features were investigated. Positive preoperative serum rates of CEA and CA19-9 were 22.4% and 12.3% respectively, levels significantly correlating with each other and depth of invasion, lymph node involvement, pTNM and stage. The CEA level also presented a remarkable association with lymphovascular invasion. Both CEA and CA19-9 positivity significantly and positively correlated with depth of invasion, nodal involvement, pTNM stage, lymphovascular invasion, tumor size and tumor location. Stratified analyses according to gender or tumor location showed preoperative CEA or CA19-9 had different associations with clinicopathologic features in different gender subgroups or location subgroups. Preoperative serum CA19-9 positivity may be more meaningful for tumor size rather than CEA. In conclusion, preoperative serum CEA and CA19-9 correlate with disease progression of GC, and may have applications in aiding more accurate estimation of tumor stage, decision of treatment choice and prognosis evaluation.
为评估术前血清癌胚抗原（CEA）和糖类抗原19-9（CA19-9）对可切除胃癌（GC）的临床影响，我们于2012年1月至2013年12月在一家三级医院回顾性收集了1075例连续的胃腺癌病例，并研究了血清CEA、CA19-9与临床病理特征之间的关系。术前血清CEA和CA19-9的阳性率分别为22.4%和12.3%，其水平彼此显著相关，且与浸润深度、淋巴结受累情况、pTNM分期及临床分期相关。CEA水平还与淋巴管侵犯显著相关。CEA和CA19-9阳性均与浸润深度、淋巴结受累情况、pTNM分期、淋巴管侵犯、肿瘤大小及肿瘤位置显著正相关。根据性别或肿瘤位置进行分层分析显示，术前CEA或CA19-9在不同性别亚组或位置亚组中与临床病理特征的关联不同。术前血清CA19-9阳性对肿瘤大小可能比CEA更有意义。总之，术前血清CEA和CA19-9与胃癌的疾病进展相关，可能有助于更准确地评估肿瘤分期、决定治疗选择及评估预后。
