Is it reasonable to add preoperative serum level of CEA and CA19-9 to staging for colorectal cancer?
Is it reasonable to add preoperative serum level of CEA and CA19-9 to staging for colorectal cancer?
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DOI：
10.1016/j.jss.2004.08.013
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发表时间：
2005-04-01
影响因子：
2.2
通讯作者：
Chang, SC
中科院分区：
文献类型：
--
作者：
Chen, CC;Yang, SH;Chang, SC
背景。癌胚抗原 (CEA) 和碳水化合物抗原 19-9 (CA19-9) 是结直肠癌最常见的肿瘤标志物。本研究的目的是通过分析它们的预后意义来评估将它们添加到当前分期系统中的可能性。材料和方法。研究人群为1994年1月至2002年8月期间接受可能治愈性结直肠腺癌（I-III期）切除术的患者（n = 574, 67.1 +/- 11.3岁，397名男性），包括术前CEA和CA19-9的测量。通过查阅现有的医疗图表来回顾性收集临床病理学特征和相关的随访数据。 CEA 高于或等于 5 ng/ml 定义为异常 (CEA+)。 CA19-9水平设定为37U/ml (CA19-9+)。根据这两个标志物的结果（CEA/CA19-9：-/-、-/+、+/-和+/+）将患者进一步分为四组（1、2、3、4）。对 AJCC 分期、CEA (+) 与 (-)、CA19-9 (+) 与 (-) 以及四组的生存率进行分析。结果。 CEA和CA19-9生存曲线没有显着差异。然而，两种标记物的联合使用显示，在 II 期中，第 1 组（两种标记物均为“-”）比第 4 组（两种标记物均为“+”）具有显着的生存获益 (P = 0.035)。结论。与这些标志物水平正常的患者相比，II 期结直肠癌 CEA 和 CA19-9 水平均升高的患者预后明显较差。我们建议将 CEA 和 CA19-9 添加到当前的分期系统中。 (C) 2005 Elsevier Inc. 保留所有权利。
Background. Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are the most common tumor markers for colorectal cancer. The aim of this study was to evaluate the possibility of adding them into the current staging system by analyzing their prognostic significance.Materials and methods. The study population was patients (n = 574, 67.1 +/- 11.3 years old, 397 males) who received potentially curative resection of colorectal adenocarcinoma (stage I-III) between January 1994 and August 2002, including preoperative measurements of CEA and CA19-9. Clinicopathological characteristics and associated follow-up data were retrospectively collected by reviewing available medical charts. CEA higher or equal to 5 ng/ml was defined as abnormal (CEA+). The CA19-9 level was set at 37U/ml (CA19-9+). Patients were further divided into four groups (1, 2, 3, 4) according to the results of these two markers (CEA/CA19-9: -/-, -/+, +/-, and +/+). Survival was analyzed for AJCC staging, CEA (+) versus (-), CA19-9 (+) versus (-), and four groups.Results. CEA and CA19-9 survival curves were not significantly different. However, the combined use of the two markers revealed a significant survival benefit (P = 0.035) of group 1 ("-" for both markers) over 4 ("+" for both) in stage II.Conclusions. Patients with an elevated level of both CEA and CA19-9 in stage II of colorectal cancer have a significantly poorer prognosis than those with normal levels of these markers. We recommend adding both CEA and CA19-9 to the current staging system. (C) 2005 Elsevier Inc. All rights reserved.