Koga T, Kano T, Souda K, Oka N, Inokuchi K
Department of Surgery, Saga Prefectural Hospital, Japan.
Jpn J Surg. 1987 Sep;17(5):342-7. doi: 10.1007/BF02470632.
Between 1980 and 1984, preoperative serum carcinoembryonic antigen (CEA) was determined in 468 patients with gastric cancer to evaluate its clinical usefulness. The positive rate of preoperative CEA was 20.9 per cent in these 468 patients. A significantly higher CEA positive rate was obtained in those patients with liver metastasis (69.2 per cent), n3-4 (40.0 per cent), stage IV gastric cancer (37.0 per cent) and Pap, Tub1 histological type (26.3 per cent) (p less than 0.01). It is interesting that the positive rate of the 49 unresectable patients was 51.0 per cent, which was significantly higher than 17.4 per cent of the 419 resectable cases (p less than 0.01). CEA levels in 16 of the 39 patients with liver metastasis were more than 100 ng/ml. In contrast, serosal invasion and peritoneal metastasis were less correlated to the CEA positive rate. In the 419 resected cases, the 5 year survival rate in the higher CEA group of more than 50 ng/ml (35 cases) was 4.4 per cent, which was significantly lower than 64.0 per cent in the negative group (346 cases) (p less than 0.01). These results show that CEA determination in patients with gastric cancer is useful for the prediction of prognosis, as well as for a diagnostic tool to discover the presence of liver or lymph node metastasis.
1980年至1984年间，对468例胃癌患者进行了术前血清癌胚抗原（CEA）检测，以评估其临床应用价值。这468例患者术前CEA阳性率为20.9%。肝转移患者（69.2%）、n3 - 4期患者（40.0%）、IV期胃癌患者（37.0%）以及乳头状、管状腺癌1型组织学类型患者（26.3%）的CEA阳性率显著更高（p < 0.01）。有趣的是，49例不可切除患者的阳性率为51.0%，显著高于419例可切除病例的17.4%（p < 0.01）。39例肝转移患者中有16例CEA水平超过100 ng/ml。相比之下，浆膜侵犯和腹膜转移与CEA阳性率的相关性较小。在419例切除病例中，CEA水平高于50 ng/ml的较高CEA组（35例）的5年生存率为4.4%，显著低于阴性组（346例）的64.0%（p < 0.01）。这些结果表明，检测胃癌患者的CEA有助于预测预后，也是发现肝或淋巴结转移的一种诊断工具。
