Moriyama Jin, Oshima Yoko, Nanami Tatsuki, Suzuki Takashi, Yajima Satoshi, Shiratori Fumiaki, Funahashi Kimihiko, Shimada Hideaki
Department of Clinical Oncology, Toho University Graduate School of Medicine, Ota-ku, Tokyo, Japan.
Department of Surgery, Toho University School of Medicine, Ota-ku, Tokyo, Japan.
Surg Today. 2021 Oct;51(10):1638-1648. doi: 10.1007/s00595-021-02248-y. Epub 2021 Mar 7.
We evaluated the clinical impact of the carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) values at the time of recurrence in gastric cancer patients.
Among 790 patients with R0 resected gastric cancer without neoadjuvant therapy between 2004 and 2017, 89 recurrence cases were retrospectively evaluated. The clinical impact of CEA and CA19-9 values on recurrence sites and post-recurrent prognosis were evaluated using univariate and multivariate analyses.
The positive rates of CEA and CA19-9 at recurrence were significantly higher than the preoperative positive rates (CEA, 56% vs 24%; CA19-9, 37% vs 15%). Although CA19-9-positive patients at recurrence exhibited a poor survival, the difference was not significant. The positive rates of CEA at liver or lymph node recurrence were significantly higher than the preoperative positive rates. The positive rate of CA19-9 at peritoneal recurrence was significantly higher than the preoperative positive rate. CA19-9-positive patients at recurrence exhibited worse prognosis than CA19-9-negative patients, although the difference was not significant. At lymph node recurrence, CA19-9-positive patients exhibited a significantly worse survival than CA19-9-negative patients.
In recurrent gastric cancer, the positive status of CA19-9 at recurrence might have a negative prognostic impact after recurrence; particularly, in patients with lymph node recurrence.
我们评估了癌胚抗原（CEA）和糖类抗原19-9（CA19-9）值在胃癌患者复发时的临床影响。
在2004年至2017年间790例未接受新辅助治疗且R0切除的胃癌患者中，对89例复发病例进行回顾性评估。使用单因素和多因素分析评估CEA和CA19-9值对复发部位和复发后预后的临床影响。
复发时CEA和CA19-9的阳性率显著高于术前阳性率（CEA，56%对24%；CA19-9，37%对15%）。虽然复发时CA19-9阳性的患者生存率较差，但差异不显著。肝或淋巴结复发时CEA的阳性率显著高于术前阳性率。腹膜复发时CA19-9的阳性率显著高于术前阳性率。复发时CA19-9阳性的患者预后比CA19-9阴性的患者差，尽管差异不显著。在淋巴结复发时，CA19-9阳性的患者生存率显著低于CA19-9阴性的患者。
在复发性胃癌中，复发时CA19-9的阳性状态可能对复发后的预后有负面的影响；特别是在淋巴结复发的患者中。
