Ikeguchi M, Katano K, Saitou H, Tsujitani S, Maeta M, Kaibara N
Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan.
Hepatogastroenterology. 1997 May-Jun;44(15):866-71.
BACKGROUND/AIMS: A retrospective study was designed to evaluate the clinical significance of preoperative serum levels of carcino-embryonic antigen (CEA) and CA72-4 in patients with advanced gastric adenocarcinoma.
Pre-operative serum levels of CEA and CA72-4 were analyzed and compared with the proliferative activity of cancer cells, monitored in terms of the number of argyrophilic nucleolar organizer regions (AgNORs), in tumors from 153 patients with resected gastric adenocarcinoma with serosal invasion.
Elevated levels of CEA were frequently found in patients with lymph node metastasis and liver metastasis. By contrast, elevated levels of CA72-4 were frequently found in patients with peritoneal metastasis at the time of operation. A close correlation was found between pre-operative levels of serum CA72-4 and the AgNOR scores of tumors. Even when apparently curative operations were performed, peritoneal metastasis occurred these were detected quite soon, after apparently curative operations in patients with high pre-operative serum levels of CA72-4 and tumors with high proliferative activity.
This phenomenon might explain the poor prognosis of patients with high levels of CA72-4.
背景/目的：开展一项回顾性研究，以评估术前血清癌胚抗原（CEA）和CA72 - 4水平在晚期胃腺癌患者中的临床意义。
分析153例已切除的伴有浆膜侵犯的胃腺癌患者术前血清CEA和CA72 - 4水平，并将其与癌细胞的增殖活性进行比较，癌细胞增殖活性通过肿瘤中嗜银核仁组织区（AgNORs）数量进行监测。
CEA水平升高常见于有淋巴结转移和肝转移的患者。相比之下，CA72 - 4水平升高常见于手术时伴有腹膜转移的患者。术前血清CA72 - 4水平与肿瘤的AgNOR评分之间存在密切相关性。即使进行了看似根治性的手术，术前血清CA72 - 4水平高且肿瘤增殖活性高的患者在看似根治性手术后很快就会发生腹膜转移并被检测到。
这种现象可能解释了CA72 - 4水平高的患者预后较差的原因。
