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糖类抗原19-9是食管胃交界腺癌中一种有用的预后标志物。

Carbohydrate antigen 19-9 is a useful prognostic marker in esophagogastric junction adenocarcinoma.

作者信息

Tokunaga Ryuma, Imamura Yu, Nakamura Kenichi, Uchihara Tomoyuki, Ishimoto Takatsugu, Nakagawa Shigeki, Iwatsuki Masaaki, Baba Yoshifumi, Sakamoto Yasuo, Miyamoto Yuji, Yoshida Naoya, Oyama Shinichiro, Shono Takashi, Naoe Hideaki, Saeki Hiroshi, Oki Eiji, Watanabe Masayuki, Sasaki Yutaka, Maehara Yoshihiko, Baba Hideo

机构信息

Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

出版信息

Cancer Med. 2015 Nov;4(11):1659-66. doi: 10.1002/cam4.514. Epub 2015 Aug 26.

Abstract

The incidence rate of esophagogastric junction (EGJ) adenocarcinoma has been rapidly increasing worldwide. Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are major serum tumor markers in gastrointestinal cancers. However, the role of these markers in EGJ adenocarcinoma has not been thoroughly investigated. A total of 211 patients with EGJ adenocarcinoma who underwent surgery or endoscopic submucosal dissection at two academic institutions, Kumamoto University Hospital or Kyushu University Hospital between January 1996 and March 2014, were eligible for this study. Serum CEA and CA19-9 were examined within 1 month before resection. The cut-off values for CEA and CA19-9 were set at 5.0 ng/mL and 37 U/mL, respectively. The clinicopathological features and prognostic roles of the markers were examined using univariate and multivariate analyses. The positive ratios for preoperative CEA (>5.0 ng/mL) and CA19-9 (>37 U/mL) were 20.3% and 12.9%, respectively. The positive ratio of CEA and CA19-9 was significantly higher in patients with tumors invading muscular or deeper layers (P = 0.002 and <0.001, respectively). Cox proportional hazards model revealed that CA19-9 positivity, but not CEA positivity, was an independent prognostic factor in patients with EGJ adenocarcinoma for cancer-specific survival (multivariate hazard ratio [HR] = 3.89, 95% confidence interval [CI] 1.41-10.33; P = 0.010) and overall survival (multivariate HR = 2.43, 95% CI 1.03-5.35; P = 0.043). Preoperative serum CA19-9 is a useful prognostic marker in patients with EGJ adenocarcinoma.

摘要

食管胃交界(EGJ)腺癌的发病率在全球范围内一直在迅速上升。癌胚抗原(CEA)和糖类抗原19-9(CA19-9)是胃肠道癌症中的主要血清肿瘤标志物。然而,这些标志物在EGJ腺癌中的作用尚未得到充分研究。1996年1月至2014年3月期间,在熊本大学医院或九州大学医院这两家学术机构接受手术或内镜黏膜下剥离术的211例EGJ腺癌患者符合本研究条件。在切除前1个月内检测血清CEA和CA19-9。CEA和CA19-9的临界值分别设定为5.0 ng/mL和37 U/mL。使用单因素和多因素分析来研究这些标志物的临床病理特征和预后作用。术前CEA(>5.0 ng/mL)和CA19-9(>37 U/mL)的阳性率分别为20.3%和12.9%。肿瘤侵犯肌层或更深层的患者中,CEA和CA19-9的阳性率显著更高(分别为P = 0.002和<0.001)。Cox比例风险模型显示,CA19-9阳性而非CEA阳性是EGJ腺癌患者癌症特异性生存(多因素风险比[HR]=3.89,95%置信区间[CI] 1.41-10.33;P = 0.010)和总生存(多因素HR = 2.43,95%CI 1.03-5.35;P = 0.043)的独立预后因素。术前血清CA19-9是EGJ腺癌患者的一种有用的预后标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a85/4673992/213f1641a967/cam40004-1659-f1.jpg

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