Qiao Yu-Feng, Chen Chuan-Gui, Yue Jie, Ma Ming-Quan, Ma Zhao, Yu Zhen-Tao
Yu-Feng Qiao, Chuan-Gui Chen, Jie Yue, Ming-Quan Ma, Zhao Ma, Zhen-Tao Yu, Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin 300060, China.
World J Gastroenterol. 2017 Feb 28;23(8):1424-1433. doi: 10.3748/wjg.v23.i8.1424.
To evaluate the clinical and prognostic significance of preoperative and postoperative cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) mRNA levels in peripheral blood of patients with gastric cardia cancer (GCC).
We detected the preoperative and postoperative mRNA levels of CK19 and CEA in peripheral blood of 129 GCC patients by using reverse transcription-polymerase chain reaction and evaluated their clinical and prognostic significance by univariate Kaplan-Meier survival analysis and multivariate Cox proportional hazard analysis. A new prognostic model which stratified patients into three different risk groups was established based on the independent prognostic factors.
Elevated preoperative and postoperative CK19 and CEA mRNA levels in peripheral blood of GCC patients were associated with lymph node metastasis. Univariate analysis showed that tumor size, histological grade, depth of tumor invasion, lymph node metastasis, preoperative CK19 mRNA, and preoperative and postoperative CEA mRNA levels were correlated with the prognosis of GCC patients. The multivariate analysis showed that lymph node status ( = 0.018), preoperative CK19 ( = 0.035) and CEA ( = 0.011) mRNA levels were independent prognostic factors for overall survival (OS). The 5-year OS rates for the low-, intermediate-, and high-risk groups were 48.3%, 22.6%, and 4.6%, respectively ( < 0.001).
Elevated preoperative CK19 and CEA mRNA levels may be regarded as promising biomarkers for predicting lymph node metastasis and poor prognosis in patients with GCC. This new prognostic model may help us identify the subpopulations of GCC patients with the highest risk.
评估贲门癌（GCC）患者术前及术后外周血中细胞角蛋白19（CK19）和癌胚抗原（CEA）mRNA水平的临床及预后意义。
采用逆转录-聚合酶链反应检测129例GCC患者术前及术后外周血中CK19和CEA的mRNA水平，并通过单因素Kaplan-Meier生存分析和多因素Cox比例风险分析评估其临床及预后意义。基于独立预后因素建立了一个将患者分为三个不同风险组的新预后模型。
GCC患者术前及术后外周血中CK19和CEA mRNA水平升高与淋巴结转移相关。单因素分析显示，肿瘤大小、组织学分级、肿瘤浸润深度、淋巴结转移、术前CK19 mRNA以及术前和术后CEA mRNA水平与GCC患者的预后相关。多因素分析显示，淋巴结状态（=0.018）、术前CK19（=0.035）和CEA（=0.011）mRNA水平是总生存（OS）时间的独立预后因素。低、中、高风险组的5年总生存率分别为48.3%、22.6%和4.6%（<0.001）。
术前CK19和CEA mRNA水平升高可被视为预测GCC患者淋巴结转移和预后不良的有前景的生物标志物。这种新的预后模型可能有助于我们识别GCC患者中风险最高的亚组。
