Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Gastric Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China.
J Surg Oncol. 2021 May;123(8):1699-1707. doi: 10.1002/jso.26446. Epub 2021 Mar 8.
Carbohydrate antigen 72-4 (CA72-4) is widely used and has been associated with poor prognosis in gastric cancer (GC), but the prognostic significance of elevated preoperative CA72-4 that normalizes after resection remains unknown.
This retrospective cohort analysis was conducted at the Sun Yat-Sen University Cancer Center (SYSUCC). Consecutive patients (n = 1179) with GC who had undergone curative resection for stage Ⅰto Ⅲ gastric adenocarcinoma. The patients were grouped into three cohorts: normal preoperative CA72-4 (C1), elevated preoperative but normalized postoperative CA72-4 (C2), and elevated preoperative and postoperative CA72-4 (C3).
In total, 1179 patients were identified. Kaplan-Meier analysis showed that patients with normal preoperative CA72-4 had a longer overall survival (OS) (p < .001) and recurrence-free survival (RFS) (p < .001) than those with elevated preoperative CA72-4. Patients with C1 had a longer OS and RFS than those with C2 or C3. Moreover, patients with C3 had the lowest OS, but had similar RFS to patients with C2. Multivariate Cox regression analysis showed that elevated pre- or postoperative CA72-4 was independently associated with shorter OS (hazard ratio [HR] = 1.273; 95% confidence interval [CI], 1.026-1.580; p = .029) and RFS (HR = 1.333; 95% CI, 1.064-1.668; p = .012).
Both elevated preoperative and postoperative CA72-4 can well predict the poor prognosis of patients with GC. Therefore, routine measurement of both postoperative and preoperative CA72-4 is warranted.
糖类抗原 72-4（CA72-4）在胃癌（GC）中广泛应用，并与不良预后相关，但术后恢复正常的术前 CA72-4 升高的预后意义尚不清楚。
本回顾性队列研究在中山大学肿瘤防治中心（SYSUCC）进行。连续纳入 1179 例接受根治性切除术治疗Ⅰ至Ⅲ期胃腺癌的 GC 患者。将患者分为三组：术前 CA72-4 正常（C1 组）、术前升高但术后正常（C2 组）和术前及术后均升高（C3 组）。
共纳入 1179 例患者。Kaplan-Meier 分析显示，术前 CA72-4 正常的患者总生存（OS）（p<0.001）和无复发生存（RFS）（p<0.001）均长于术前 CA72-4 升高的患者。C1 组的 OS 和 RFS 均长于 C2 或 C3 组。此外，C3 组的 OS 最短，但与 C2 组的 RFS 相似。多因素 Cox 回归分析显示，术前或术后 CA72-4 升高与较短的 OS（风险比[HR]，1.273；95%置信区间[CI]，1.026-1.580；p=0.029）和 RFS（HR，1.333；95%CI，1.064-1.668；p=0.012）独立相关。
术前和术后 CA72-4 升高均能很好地预测 GC 患者的不良预后。因此，有必要常规测量术后和术前 CA72-4。
