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胃癌中的糖类抗原19-9、癌胚抗原和糖类抗原72-4:老歌还在奏响吗?

Carbohydrate Antigen 19-9, Carcinoembryonic Antigen, and Carbohydrate Antigen 72-4 in Gastric Cancer: Is the Old Band Still Playing?

作者信息

Kotzev Andrey Iskrenov, Draganov Peter Vassilev

机构信息

Clinic of Gastroenterology, University Hospital "Alexandrovska," Medical University Sofia, Sofia, Bulgaria.

Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida, USA.

出版信息

Gastrointest Tumors. 2018 Sep;5(1-2):1-13. doi: 10.1159/000488240. Epub 2018 Apr 24.

Abstract

BACKGROUND

Gastric cancer (GC) is characterized by aggressive behavior and a high mortality rate. The diagnosis of GC is challenging because the GC is often diagnosed in an advanced stage. The use of tumor markers is a putative way to improve the detection and treatment in patients with GC.

SUMMARY

In this article, we review the significance of serum carbohydrate antigen (CA) 19-9, carcinoembryonic antigen (CEA), and CA 72-4 in GC. The results from different studies regarding the diagnostic and prognostic role of CA 19-9, CEA, and CA 72-4 in GC are encouraging, but inadequate sensitivity and specificity obstruct their use as standardized and unconditionally reliable markers in GC. New prospective clinical trials are mandatory for clarifying their value in GC.

KEY MESSAGE

CA 19-9, CEA, and CA 72-4 should not be used for screening and early diagnosis in GC, whereas they are beneficial in the detection of late GC. CA 19-9, CEA, and CA 72-4 could be used as prognostic and monitoring tools in GC, and their combined measurement in shorter periods of time is the best method to increase sensitivity and specificity.

PRACTICAL IMPLICATIONS

Serum CA 19-9, CEA, and CA 72-4 are useful diagnostic and prognostic tumor markers in GC.

摘要

背景

胃癌(GC)具有侵袭性,死亡率高。胃癌的诊断具有挑战性,因为其往往在晚期才被诊断出来。使用肿瘤标志物是改善胃癌患者检测和治疗的一种可能方法。

总结

在本文中,我们综述了血清糖类抗原(CA)19-9、癌胚抗原(CEA)和CA 72-4在胃癌中的意义。关于CA 19-9、CEA和CA 72-4在胃癌中的诊断和预后作用的不同研究结果令人鼓舞,但灵敏度和特异性不足阻碍了它们作为胃癌标准化且无条件可靠标志物的应用。新的前瞻性临床试验对于明确它们在胃癌中的价值至关重要。

关键信息

CA 19-9、CEA和CA 72-4不应被用于胃癌的筛查和早期诊断,而它们在晚期胃癌的检测中是有益的。CA 19-9、CEA和CA 72-4可作为胃癌的预后和监测工具,在较短时间内联合检测是提高灵敏度和特异性的最佳方法。

实际意义

血清CA 19-9、CEA和CA 72-4是胃癌中有用的诊断和预后肿瘤标志物。

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