肿瘤标志物在评估不可切除胰腺癌放疗反应中的应用

Tumor markers in evaluating the response to radiotherapy in unresectable pancreatic cancer.

作者信息

Okusaka T, Okada S, Sato T, Wakasugi H, Saisho H, Furuse J, Ishikawa O, Matsuno S, Yokoyama S

机构信息

Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.

出版信息

Hepatogastroenterology. 1998 May-Jun;45(21):867-72.

PMID:9684148

Abstract

BACKGROUND/AIMS: Serum carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) are useful tumor markers in the diagnosis of pancreatic cancer. However, little research has shown their value for evaluating the response to radiotherapy in patients with advanced pancreatic cancer.

METHODOLOGY

Serial changes of serum CA 19-9 levels were studied in 34 patients with unresectable pancreatic cancer. All patients had a CA 19-9 level of 100 U/ml or greater before treatment and received radiotherapy as an initial treatment. A CA 19-9 responder was defined as a patient whose serum CA 19-9 level was reduced by more than 50% of the pre-treatment level after treatment. We investigated the relationship between CA 19-9 response and survival. We also studied serial changes of serum CEA levels in 20 patients with the level of 5 ng/ml or greater before radiotherapy, and investigated the relationship between CEA response and survival.

RESULTS

CA 19-9 response and CEA response were observed in seven (21%) of 34 patients and four (20%) of 20 patients, respectively. Median survival times of CA 19-9 responders and non-responders were 318 and 122 days, respectively, and median survival times of CEA responders and non-responders were 281 and 151 days, respectively. Based on results of the Cox regression analysis, the relative rates of cancer death between responders and non-responders were 0.24 (95% confidence interval, 0.08 to 0.72) in the CA 19-9 analysis and 0.19 (95% confidence interval, 0.04 to 0.84) in the CEA analysis.

CONCLUSION

Serum CA 19-9 may be useful tumor markers for assessing the effectiveness of radiotherapy for pancreatic cancer. Further investigations are necessary to determine the value of CEA.

摘要

背景/目的：血清糖类抗原19-9（CA 19-9）和癌胚抗原（CEA）是胰腺癌诊断中有用的肿瘤标志物。然而，很少有研究表明它们在评估晚期胰腺癌患者放疗反应方面的价值。

方法

对34例不可切除胰腺癌患者的血清CA 19-9水平的系列变化进行了研究。所有患者在治疗前CA 19-9水平均≥100 U/ml，并接受放疗作为初始治疗。CA 19-9反应者定义为治疗后血清CA 19-9水平降低超过治疗前水平50%的患者。我们研究了CA 19-9反应与生存之间的关系。我们还研究了20例放疗前CEA水平≥5 ng/ml患者的血清CEA水平的系列变化，并研究了CEA反应与生存之间的关系。

结果

34例患者中有7例（21%）出现CA 19-9反应，20例患者中有4例（20%）出现CEA反应。CA 19-9反应者和无反应者的中位生存时间分别为318天和122天，CEA反应者和无反应者的中位生存时间分别为281天和151天。基于Cox回归分析结果，CA 19-9分析中反应者与无反应者之间的癌症死亡相对率为0.24（95%置信区间，0.08至0.72），CEA分析中为0.19（95%置信区间，0.04至0.84）。