Kodera Y, Yamamura Y, Torii A, Uesaka K, Hirai T, Yasui K, Morimoto T, Kato T, Kito T
Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan.
Am J Gastroenterol. 1996 Jan;91(1):49-53.
The clinical significance of preoperative serum levels of tumor markers CEA and CA19-9 was evaluated in gastric cancer patients.
Serum levels of CEA and CA19-9 were measured in 663 patients with gastric cancer who underwent laparotomies over a recent 4-yr period (1990-1993). The correlations between the serum levels of tumor markers and several clinicopathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factors was assessed by multivariate analysis.
The positivity rates of CEA and CA19-9 were 16.6% and 16.0%, respectively. The positivity of CEA correlated well with the sex of the patients, hepatic, peritoneal, and nodal metastases and the depths of tumors, but it correlated weakly with a tumor's histological type. The positivity of CA19-9 correlated well with various forms of metastases, depths, and tumor size. A significant in prognosis was observed between patients positive and negative for CA19-9 among those undergoing R0 resection. Multivariate analysis also revealed that serum CA19-9 was better than CEA as a prognostic factor.
CA19-9 in the preoperative sera is a good prognostic factor in gastric cancer patients, although tumor markers continue to have only limited diagnostic usefulness.
评估胃癌患者术前血清肿瘤标志物癌胚抗原（CEA）和糖类抗原19-9（CA19-9）水平的临床意义。
对663例在最近4年（1990 - 1993年）接受剖腹手术的胃癌患者测定血清CEA和CA19-9水平。通过单因素分析评估肿瘤标志物血清水平与多种临床病理因素之间的相关性。通过多因素分析评估肿瘤标志物作为预后因素的意义。
CEA和CA19-9的阳性率分别为16.6%和16.0%。CEA的阳性与患者性别、肝转移、腹膜转移、淋巴结转移及肿瘤深度密切相关，但与肿瘤组织学类型相关性较弱。CA19-9的阳性与各种转移形式、肿瘤深度及肿瘤大小密切相关。在接受R0切除的患者中，CA19-9阳性和阴性患者之间观察到显著的预后差异。多因素分析还显示，血清CA19-9作为预后因素优于CEA。
术前血清中的CA19-9是胃癌患者的一个良好预后因素，尽管肿瘤标志物的诊断价值仍然有限。
