General and Emergency Surgery, Santa Maria della Misericordia Hospital-University of Perugia, Via dottori, 06132, Perugia, Italy.
Updates Surg. 2023 Aug;75(5):1211-1217. doi: 10.1007/s13304-023-01542-3. Epub 2023 Jun 22.
The aim of this study is to define the importance of peritoneal CEA (pCEA) as a prognostic factor of overall survival (OS) and disease-free survival (DFS) in gastric cancer (GC) patients surgically treated with a curative intent In our department. A total of 64 patients affected by gastric cancer with intraoperatively measurement of CEA on peritoneal lavage were enrolled in the study. Patients were divided into two groups: (A) the peritoneal lavage CEA ( -) with CEA < 0.5 ng/ml and (B) the peritoneal lavage CEA ( +) with CEA ≥ 0.5 ng/ml. Then we analyzed OS and DFS of the two groups correlating them to others clinico-pathological features. Furthermore, we investigated the correlation between pCEA and peritoneal cytology. We demonstrated a strong significant difference in OS and in DFS in CEA ( +) patients. We emphasized that pCEA had a strong survival impact, in both OS and DFS, in selected patients affected by diffuse histotype GC (p = 0.0048 and p = 0.0030 respectively), stage III (p = 0.015 and p = 0.021, respectively) and distal gastric cancer (p = 0.0036 and p = 0.0017, respectively). There is a strong need to recognize prognostic factors that can help clinicians to stratify patients at high risk to develop post-surgical recurrences and moreover to recognize who could benefit from an aggressive surgical treatment of cytoreductive surgery and intra-peritoneal chemotherapy.pCEA is a good predictor of survival in advanced gastric cancer and could discriminate which patients need a more accurate follow-up program and an intensive therapeutic strategy.
本研究旨在确定腹膜 CEA（pCEA）作为有治愈意图手术治疗的胃癌（GC）患者总生存（OS）和无病生存（DFS）的预后因素的重要性。在我们科室，共有 64 名接受 GC 手术治疗且术中对腹腔灌洗液进行 CEA 测量的患者入组本研究。患者分为两组：（A）腹膜灌洗液 CEA（-），CEA<0.5ng/ml；（B）腹膜灌洗液 CEA（+），CEA≥0.5ng/ml。然后我们分析了两组患者的 OS 和 DFS，并将其与其他临床病理特征相关联。此外，我们还研究了 pCEA 与腹膜细胞学之间的相关性。我们发现 CEA（+）患者的 OS 和 DFS 存在显著差异。我们强调，在弥漫型 GC（p=0.0048 和 p=0.0030）、III 期（p=0.015 和 p=0.021）和远端胃癌（p=0.0036 和 p=0.0017）患者中，pCEA 对 OS 和 DFS 具有强烈的生存影响。强烈需要识别预后因素，以帮助临床医生对有术后复发高风险的患者进行分层，并且需要识别出哪些患者可以从减瘤手术和腹腔内化疗的强化治疗中获益。pCEA 是晚期 GC 生存的良好预测因子，可以区分哪些患者需要更准确的随访计划和强化治疗策略。
