Evaluation of serum CEA and CA19-9 levels as prognostic factors in patients with gastric cancer.
Evaluation of serum CEA and CA19-9 levels as prognostic factors in patients with gastric cancer.
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DOI：
10.1007/pl00011715
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发表时间：
2000-12-01
期刊：
影响因子：
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通讯作者：
Yamagata, Motoo
中科院分区：
文献类型：
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作者：
Kochi, Mitsugu;Fujii, Masashi;Yamagata, Motoo
背景技术背景：本临床病理学研究评估了血清癌胚抗原（CEA）和糖链抗原（CA）19-9作为局部复发和长期无病生存的预测指标在胃癌patients.METHODS：在1989年1月至1994年12月期间，485例原发性胃癌患者进行了评估。胃切除术434例。预后因素进行了分析的Kaplan-Meier法和多因素分析，使用考克斯regulation.Results：血清CEA和CA 19 -9水平升高观察到92的485例（19.0%），95的435例（21.8%），分别，这两个标志物均升高，在这435例（6.7%）。血清CEA和CA 19 -9水平升高与淋巴结转移、淋巴管浸润、脉管浸润、分期分组、浸润深度和可治愈性密切相关。血清CEA水平升高的患者比血清CEA水平正常的患者有更高的复发风险。血清CA 19 -9水平升高的患者发生腹膜转移和远处转移的风险显著高于血清CA 19 -9水平正常的患者。在血清CEA或CA 19 -9水平升高的患者和血清CEA或CA 19 -9水平正常的患者之间，即使对于处于相同疾病阶段（III期）的患者，累积生存曲线也存在显著差异。两种标志物水平升高的患者比两种标志物水平均正常的患者预后显著更差。在接受胃切除术的患者中，术前或胃切除术后3周内血清CEA水平升高与正常水平相比预后显著较差。当血清CEA的临界值提高到10 ng/ml时，血清CEA、年龄、淋巴结转移和手术分期被选为独立的预后因素，采用考克斯回归分析14个预后因素。特别是，血清CEA水平升高提供了额外的预后信息，并且是经历胃切除术的患者的可治愈性的有用指标。血清CEA水平是影响胃癌患者预后的独立因素。
BACKGROUND: This clinicopathological study evaluated the utility of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 as predictors of locoregional recurrence and long-term disease-free survival in patients with gastric cancer.METHODS: During the period January 1989 to December 1994, 485 patients with primary gastric cancer were evaluated. Gastrectomies were performed in 434 patients. Prognostic factors were analyzed by the Kaplan-Meier method and multivariate analysis, using Cox regression.RESULTS: Elevated serum CEA and CA19-9 levels were observed in 92 of the 485 patients (19.0%), and in 95 of the 435 patients (21.8%), respectively, and both markers were elevated in 29 of these 435 patients (6.7%). Elevated serum CEA and CA19-9 levels correlated well with lymph node metastasis, lymphatic invasion, vessel invasion, stage grouping, depth of invasion, and curability. Patients with elevated serum CEA levels were at significantly higher risk of having all recurrence factors than were those with normal serum CEA levels. Patients with elevated serum CA19-9 levels were at significantly higher risk of having peritoneal metastases and distant metastases than were those with normal serum CA19-9 levels. A significant difference in the cumulative survival curves of patients was demonstrated between those with elevated and those with normal serum CEA or CA19-9 levels, even for patients at the same disease stage (stage III). Patients with elevated levels of both markers had a significantly worse prognosis than patients in whom the levels of both markers were normal. In patients who underwent gastrectomy, elevated serum CEA levels either preoperatively or within 3 weeks after gastrectomy were associated with significantly worse prognosis than were normal levels. When the cutoff level of serum CEA was increased to 10 ng/ml, serum CEA, age, lymph node metastasis, and surgical stage grouping were selected as independent prognostic factors by multivariate analysis of 14 prognostic factors, using Cox regression.CONCLUSION: Serum CEA and CA19-9 levels provide additional prognostic information in patients with primary gastric cancer. In particular, an elevated serum CEA level provides additional prognostic information and is a useful indicator of curability in patients who undergo gastrectomy. Serum CEA level is an independent prognostic factor in patients with primary gastric cancer.