Association of Preoperative Serum Carcinoembryonic Antigen and Gastric Cancer Recurrence: A Large Cohort Study.
Association of Preoperative Serum Carcinoembryonic Antigen and Gastric Cancer Recurrence: A Large Cohort Study.
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术前血清癌胚抗原与胃癌复发的关联：一项大型队列研究
DOI：
10.7150/jca.47899
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发表时间：
2021
影响因子：
3.9
通讯作者：
He Y
中科院分区：
文献类型：
--
作者：
Cai Q;Zhou W;Li J;Ou X;Chen C;Cai S;He W;Xu J;He Y
背景和目的：指南建议术后检测癌胚抗原（CEA），以帮助检测胃癌患者的复发。然而，术前CEA升高的预后意义尚不清楚。本研究旨在探讨术前CEA升高的患者是否比术前CEA正常的患者有更高的复发风险。方法：我们在中国南方的一个胃癌中心进行了一项回顾性队列研究。确定了2001年1月至2016年2月在中心接受根治性切除术的I至III期胃腺癌连续患者。将患者分为两组：术前CEA正常（≤ 5 ng/ml）和术前CEA升高（> 5 ng/ml）。3-年无复发生存率（RFS）和风险函数曲线随时间的推移进行了估计。结果：共确定了1，596例患者（1，063例{66.6%}男性;中位{四分位距，IQR}年龄为59 {50-66}岁）。术前CEA升高的患者的3年RFS（n=222 {70.4%}）比术前CEA正常的队列（n= 1，374 {85.9%}）低15.5%。两个队列的复发风险函数在相似的时间（术后约10个月）达到峰值。多变量考克斯分析证实，术前CEA升高与RFS缩短独立相关（风险比{HR}，1.69; 95%置信区间{CI}，1.26-2.27; P = 0.001）。结论：术前CEA升高的患者复发的风险增加，尤其是在手术后的前24个月内。
Background and Aim: Measuring postoperative carcinoembryonic antigen (CEA) is recommended by guidelines to help detecting recurrence of gastric cancer patients. However, the prognostic significance of elevated preoperative CEA is unclear. This study aims to investigate whether patients with elevated preoperative CEA have a higher risk of recurrence than patients with normal preoperative CEA. Methods: We conducted a retrospective cohort study at a gastric cancer center in South China. Consecutive patients with stage I to III gastric adenocarcinoma who underwent curative resection at the center from January 2001 to February 2016 were identified. Patients were grouped into two cohorts: normal preoperative CEA (≤ 5 ng/ml), and elevated preoperative CEA (> 5 ng/ml). 3-year recurrence-free survival (RFS) and hazard function curves over time were estimated. Results: A total of 1,596 patients (1,063 {66.6%} male; median {Interquartile range, IQR} age, 59 {50-66} years) were identified. Patients with elevated preoperative CEA had 15.5% lower 3-year RFS (n=222 {70.4%}) than the cohorts with normal preoperative CEA (n=1,374 {85.9%}). The hazard function of recurrence for the two cohorts peaked at the similar time (around 10 months after surgery). Multivariate Cox analyses confirmed that elevated preoperative CEA was independently associated with shorter RFS (Hazard Ratio {HR}, 1.69; 95% confidence interval {CI}, 1.26-2.27; P = 0.001). Conclusions: Patients with elevated preoperative CEA are at increased risk for recurrence, especially within the first 24 months after surgery.
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影响因子：
2
作者：
Aloe, S;D'Alessandro, R;Guadagni, F
通讯作者：
Guadagni, F
影响因子：
2.5
作者：
Çetin, B;Atalay, C;Çetin, A
通讯作者：
Çetin, A
影响因子：
8.8
作者：
Jiang, X.;Hiki, N.;Nunobe, S.;Kumagai, K.;Kubota, T.;Aikou, S.;Sano, T.;Yamaguchi, T.
通讯作者：
Yamaguchi, T.
影响因子：
11.2
作者：
Li Y;Cao H;Jiao Z;Pakala SB;Sirigiri DN;Li W;Kumar R;Mishra L
通讯作者：
Mishra L
DOI：
10.6004/jnccn.2014.0085
发表时间：
2014-06
期刊：
Journal of the National Comprehensive Cancer Network : JNCCN
影响因子：
--
作者：
Litvak A;Cercek A;Segal N;Reidy-Lagunes D;Stadler ZK;Yaeger RD;Kemeny NE;Weiser MR;Pessin MS;Saltz L
通讯作者：
Saltz L