Department of Myxoma, Aerospace Center Hospital, 15 Yuquan Road, Haidian, 100049, Beijing, China.
Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, 10 Tieyi Road, Haidian, 100038, Beijing, China.
BMC Cancer. 2023 Jan 26;23(1):90. doi: 10.1186/s12885-023-10545-7.
To investigate the expression of carcinoembryonic antigen (CEA), cancer antigen 199 (CA199) and CA125 in serum and ascites of appendiceal pseudomyxoma peritonei (PMP) patients relative to their diagnostic and predictive value.
The study comprised 183 patients with pathologically confirmed appendiceal PMP, enrolled from May 2012 to June 2020, in Aerospace Center Hospital. Serum and ascites tumor markers were obtained, and their diagnostic values were compared by receiver operating characteristic (ROC) curves. The prognostic factors of appendiceal PMP with different pathologic subgroups were calculated by univariate and multivariate Cox proportional hazard regression models.
There were significant differences between the numbers of patients with positive CEA and CA199 in serum vs. ascites: p = 0.034 in CEA and p = 0.006 in CA199, respectively. The sensitivities with optimal cut-off values for ascites markers of CEA, CA199 and CA125 were 83.5%, 88.9% and 72.6%, respectively. CEA in ascites showed significant difference in the diagnosis of appendiceal PMP (p = 0.000); the areas under the ROC curves (AUROCs) and specificity were 0.725, 70.7%, respectively. Univariate analysis showed that the higher the ascites tumor markers, the poorer the survival (p = 0.014). Multivariate analysis indicated that completeness of cytoreduction (CCR), ascites CEA and pathological grade were independent risk factors for overall survival (OS).
CEA in ascites can be used to help specify the origin of PMP. Furthermore, elevation of ascites CEA, high pathological grade and incomplete cytoreduction predicted poor prognosis of appendiceal PMP.
研究癌胚抗原（CEA）、肿瘤抗原 199（CA199）和 CA125 在阑尾假性黏液瘤腹膜假黏液瘤（PMP）患者血清和腹水中的表达及其诊断和预测价值。
本研究纳入了 2012 年 5 月至 2020 年 6 月期间在航天中心医院经病理证实的 183 例阑尾 PMP 患者。收集血清和腹水肿瘤标志物，并通过接受者操作特征（ROC）曲线比较其诊断价值。采用单因素和多因素 Cox 比例风险回归模型计算不同病理亚组阑尾 PMP 的预后因素。
血清和腹水中 CEA 和 CA199 阳性患者人数存在差异：CEA 为 p=0.034，CA199 为 p=0.006。腹水标志物 CEA、CA199 和 CA125 的最佳截断值的灵敏度分别为 83.5%、88.9%和 72.6%。腹水 CEA 对阑尾 PMP 的诊断有显著差异（p=0.000）；ROC 曲线下面积（AUROC）和特异性分别为 0.725 和 70.7%。单因素分析显示，腹水肿瘤标志物越高，生存越差（p=0.014）。多因素分析表明，完全肿瘤细胞减灭术（CCR）、腹水 CEA 和病理分级是总生存（OS）的独立危险因素。
腹水 CEA 可用于帮助确定 PMP 的来源。此外，腹水 CEA 升高、高病理分级和不完全肿瘤细胞减灭术预测阑尾 PMP 预后不良。
