Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, China.
Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.
J Gastrointest Surg. 2024 May;28(5):694-702. doi: 10.1016/j.gassur.2024.02.023. Epub 2024 Feb 20.
This study aimed to assess the utility of 6 serum tumor markers in prognosis between gastric adenocarcinoma and gastric signet ring cell carcinoma (SRCC).
A cohort of 3131 cases of gastric adenocarcinoma and 275 cases of gastric SRCC was assembled. The serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125, alpha fetoprotein (AFP), carbohydrate antigen 242 (CA242), and carbohydrate antigen 724 (CA724) were measured in all cases. The study analyzed the association between the levels of these 6 tumor markers and the prognosis of gastric adenocarcinoma and SRCC.
The study revealed that gastric SRCC exhibited lower concentrations of CEA (P < .001) and CA19-9 (P = .002), along with reduced positive rates of CEA (P = .041), CA19-9 (P = .003), AFP (P < .001), and CA242 (P = .006), while displaying higher positive rates of CA724 (P = .024) than gastric adenocarcinoma. Nevertheless, the receiver operating characteristic curve demonstrated that serum tumor markers did not hold clinical significance in differentiating between gastric adenocarcinoma and SRCC. Survival analysis substantiated that the combined criteria of serum tumor markers stood as an independent risk factor for both gastric adenocarcinoma and SRCC. Notably, the nomogram indicated that serum tumor markers exerted a more substantial influence on the prognosis of gastric adenocarcinoma than on gastric SRCC.
The study concluded that the combined criteria of serum tumor markers emerge as independent risk factors for both subtypes of gastric cancer. Furthermore, this combined approach exhibited enhanced efficacy in prognosticating the outcome of gastric adenocarcinoma compared with gastric SRCC.
本研究旨在评估 6 种血清肿瘤标志物在胃腺癌和胃印戒细胞癌(SRCC)之间预后中的应用价值。
收集了 3131 例胃腺癌和 275 例胃 SRCC 患者的队列。测量所有患者的癌胚抗原(CEA)、糖类抗原 19-9(CA19-9)、糖类抗原 125、甲胎蛋白(AFP)、糖类抗原 242(CA242)和糖类抗原 724(CA724)的血清水平。本研究分析了这些 6 种肿瘤标志物的水平与胃腺癌和 SRCC 预后之间的关系。
研究表明,胃 SRCC 的 CEA(P<0.001)和 CA19-9(P=0.002)浓度较低,CEA(P=0.041)、CA19-9(P=0.003)、AFP(P<0.001)和 CA242(P=0.006)的阳性率降低,而 CA724(P=0.024)的阳性率升高。然而,受试者工作特征曲线表明,血清肿瘤标志物在区分胃腺癌和 SRCC 方面没有临床意义。生存分析证实,血清肿瘤标志物的联合标准是胃腺癌和 SRCC 的独立危险因素。值得注意的是,列线图表明,血清肿瘤标志物对胃腺癌的预后影响大于对胃 SRCC 的影响。
研究表明,血清肿瘤标志物联合标准是两种胃癌亚型的独立危险因素。此外,与胃 SRCC 相比,这种联合方法在预测胃腺癌的预后方面更有效。