甲胎蛋白用于胃癌分期：必要的还是多余的肿瘤标志物？

Alpha-fetoprotein for Gastric Cancer Staging: An Essential or Redundant Tumor Marker?

机构信息

Department of General Surgery, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.

Department of Gastroenterology and Hepatology, Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.

出版信息

Anticancer Res. 2021 May;41(5):2711-2718. doi: 10.21873/anticanres.15052.

DOI:10.21873/anticanres.15052

PMID:33952502

Abstract

BACKGROUND/AIM: This study was designed to clarify the value of routine alpha-fetoprotein (AFP) testing for patients with gastric cancer (GC).

PATIENTS AND METHODS

A total of 905 patients with newly diagnosed GC and available pretreatment carcinoembryonic antigen (CEA), cancer-related antigen 19-9 (CA19-9), and AFP data from 2010 to 2016 were collected for comparison of tumor stage and survival.

RESULTS

In total, 139 patients (15.4%), 155 patients (17.1%), and 27 patients (3.0%) had elevated CEA, CA19-9, and AFP levels, respectively. The c-index values of elevated AFP levels in predicting stage IV disease and the 1-year mortality rate were 0.564 (95%CI=0.520-0.608) and 0.594 (95%CI=0.553-0.635), respectively, which were significantly lower than those of CEA (0.673 and 0.665) and CA19-9 (0.619 and 0.618).

CONCLUSION

Elevated AFP is rare in patients with newly diagnosed GC. Routine AFP sampling would not provide a higher survival prediction in GC patients than CEA or CA19-9.

摘要

背景/目的：本研究旨在阐明常规甲胎蛋白（AFP）检测对胃癌（GC）患者的价值。

患者与方法

共收集了 905 例 2010 年至 2016 年间新诊断为 GC 且术前癌胚抗原（CEA）、癌相关抗原 19-9（CA19-9）和 AFP 数据可用的患者，用于比较肿瘤分期和生存情况。

结果

共有 139 例（15.4%）、155 例（17.1%）和 27 例（3.0%）患者的 CEA、CA19-9 和 AFP 水平升高。升高的 AFP 水平预测 IV 期疾病和 1 年死亡率的 c 指数值分别为 0.564（95%CI=0.520-0.608）和 0.594（95%CI=0.553-0.635），明显低于 CEA（0.673 和 0.665）和 CA19-9（0.619 和 0.618）。