CA724 预测新辅助化疗局部晚期胃癌患者的总生存期。
CA724 predicts overall survival in locally advanced gastric cancer patients with neoadjuvant chemotherapy.
机构信息
Department of Gastric Surgery, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, No 44 of Xiaoheyan Road, Dadong District, Liaoning, 110042, Shenyang, China.
出版信息
BMC Cancer. 2021 Jan 5;21(1):4. doi: 10.1186/s12885-020-07666-8.
BACKGROUND
Serum tumor markers including AFU, AFP, CEA, CA199, CA125 and CA724, are of great importance in the diagnosis, prognostic prediction and recurrence monitoring of gastrointestinal malignancies. However, their significance in gastric cancer (GC) patients with neoadjuvant therapy (NCT) is still uncertain. The aim of this study was to evaluate the predictive value of these six tumor markers in locally advanced GC patients who underwent NCT and curative surgery.
METHODS
In total, 290 locally advanced GC patients who underwent NCT and D2 radical gastrectomy were retrospectively analyzed. Data on their tumor markers before (pre-) and after (post-) NCT and pathological characteristics were extracted from the database of our hospital. The optimal cutoff values of the six tumor markers were calculated by the ROC curve and Youden index. Their predictive significance was analyzed and survival curves for overall survival (OS) were obtained by the Kaplan-Meier method. Associations between categorical variables were explored by the chi-square test or Fisher's exact test. Multivariate analyses were performed by the Cox regression model.
RESULTS
Pre- and post-CA199, -CA125 and -CA724 could predict overall survival (all P < 0.05), but only the change (diff-) of CA199 was related to prognosis (P = 0.05). In the multivariable analysis, pre- (P = 0.014) and post-CA724 (P = 0.036) remained significant, though diff-CA724 was not an independent prognostic factor (P = 0.581). In addition, pre- and post-CA199, -CA125 and -CA724 were associated with lymph node metastasis (N- vs N+) and pathological stage (I-II vs III) (all P < 0.05). Moreover, post-CA724 was related to the vascular or lymphatic invasion (P = 0.019), while pre-CA724 was not (P = 0.082). However, AFU, AFP and CEA showed no association with survival (P > 0.05).
CONCLUSIONS
CA724 is an independent factor for prognosis and could be used to predict ypN and ypTNM stage in locally advanced GC patients undergoing NCT and curative resection.
背景
血清肿瘤标志物包括 AFU、AFP、CEA、CA199、CA125 和 CA724，在胃肠道恶性肿瘤的诊断、预后预测和复发监测中具有重要意义。然而，它们在接受新辅助治疗（NCT）的胃癌（GC）患者中的意义仍不确定。本研究旨在评估这些六种肿瘤标志物在接受 NCT 和根治性胃切除术后局部晚期 GC 患者中的预测价值。
方法
回顾性分析 290 例接受 NCT 和 D2 根治性胃切除术的局部晚期 GC 患者。从我院数据库中提取他们在 NCT 前后（pre-和 post-）的肿瘤标志物数据和病理特征。通过 ROC 曲线和 Youden 指数计算六种肿瘤标志物的最佳截断值。通过 Kaplan-Meier 法获得总生存期（OS）的生存曲线，并分析其预测意义。通过卡方检验或 Fisher 确切检验探索分类变量之间的关系。通过 Cox 回归模型进行多变量分析。
结果
pre-和 post-CA199、-CA125 和 -CA724 可预测总生存期（均 P<0.05），但仅 CA199 的变化（diff-）与预后相关（P=0.05）。在多变量分析中，pre-（P=0.014）和 post-CA724（P=0.036）仍然具有显著性，尽管 diff-CA724 不是独立的预后因素（P=0.581）。此外，pre-和 post-CA199、-CA125 和 -CA724 与淋巴结转移（N- vs N+）和病理分期（I-II vs III）有关（均 P<0.05）。此外，post-CA724 与血管或淋巴管侵犯有关（P=0.019），而 pre-CA724 则无关（P=0.082）。然而，AFU、AFP 和 CEA 与生存无关（P>0.05）。
结论
CA724 是预后的独立因素，可用于预测接受 NCT 和根治性切除的局部晚期 GC 患者的ypN 和 ypTNM 分期。
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