Nakata B, Hirakawa-YS Chung K, Kato Y, Yamashita Y, Maeda K, Onoda N, Sawada T, Sowa M
First Department of Surgery, Osaka City University Medical School, Osaka, Japan.
Cancer. 1998 Dec 15;83(12):2488-92. doi: 10.1002/(sici)1097-0142(19981215)83:12<2488::aid-cncr12>3.0.co;2-1.
Prediction of peritoneal dissemination is very difficult using current diagnostic tools such as computed tomography, ultrasonography, or various tumor markers. The predictive value of serum CA 125 levels for peritoneal metastasis from gastric carcinoma was studied.
The sera from 384 patients with gastric carcinoma were measured for CA 125 titer using an immunoradiometric assay. Carcinoembryonic antigen, carbohydrate antigen 19-9, and sialyl-Tn antigen were measured in the same samples.
The serum CA 125 level was elevated according to the degree of peritoneal dissemination. The reference value for peritoneal dissemination was determined to be 35 U/mL, resulting in a sensitivity of 39.4%, specificity of 95.7%, and diagnostic accuracy of 90.8%. The diagnostic ability was more reliable than the other imaging modalities including computed tomography and ultrasonography and the other useful tumor markers for gastric carcinoma. The serum CA 125 level was elevated after gastrectomy for approximately 2 months, most likely due to the continuous inflammation of the peritoneum and lost predictive significance for peritoneal dissemination during this period.
Measurement of the serum CA 125 titer may be a powerful predictor of peritoneal metastases in patients with gastric carcinoma.
使用当前的诊断工具，如计算机断层扫描、超声检查或各种肿瘤标志物，很难预测腹膜播散。本研究探讨血清CA 125水平对胃癌腹膜转移的预测价值。
采用免疫放射分析法检测384例胃癌患者血清CA 125水平。同时检测同一批样本中的癌胚抗原、糖类抗原19-9和唾液酸-Tn抗原。
血清CA 125水平随腹膜播散程度升高。确定腹膜播散的参考值为35 U/mL，敏感性为39.4%，特异性为95.7%，诊断准确性为90.8%。其诊断能力比包括计算机断层扫描和超声检查在内的其他成像方式以及胃癌的其他有用肿瘤标志物更可靠。胃癌切除术后血清CA 125水平升高约2个月，最可能是由于腹膜持续炎症，在此期间对腹膜播散失去预测意义。
检测血清CA 125水平可能是胃癌患者腹膜转移的有力预测指标。
