Serum HCGβ and CA 72-4 are stronger prognostic factors than CEA, CA 19-9 and CA 242 in pancreatic cancer
Serum HCGβ and CA 72-4 are stronger prognostic factors than CEA, CA 19-9 and CA 242 in pancreatic cancer
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DOI：
10.1159/000077438
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发表时间：
2004-01-01
期刊：
影响因子：
3.5
通讯作者：
Haglund, C
中科院分区：
文献类型：
--
作者：
Louhimo, J;Alfthan, H;Haglund, C
目的：在胰腺癌中，疾病的扩散程度被认为是最强的预后因素。此外，肿瘤标志物，特别是CA 199，也可以提供预后信息。在本研究中，我们评估了血清肿瘤标志物CEA、CA 19-9、CA 242、CA 72-4和hCG β在胰腺癌中的预后价值。研究方法：从160名胰腺癌患者中获得术前血清样品，包括10名I期患者，25名II期患者，24名III期患者和101名IV期癌症患者。血清中CEA、CA 19-9、CA 242和CA 72-4的定量用商业测定法进行。采用基于游离hCG β亚基特异性单克隆抗体的内部免疫荧光测定法测量HCG β。生存分析采用单因素Kaplan-Meier寿命表和log-rank检验，多因素考克斯回归分析。结果：在研究的肿瘤标志物中，CA 19-9最常升高。2年生存率为10%。单因素分析发现，分期、肿瘤位置和大小、根治性切除、CEA、CA 72-4和hCG β均为预后因素（p < 0.026）。在多变量分析中，当单独分析但调整分期时，每个标记物具有独立的预后价值（p < 0.011）。当所有的协变量都包含在同一模型中时，最强的预后因素是hCG β，其次是CA 72-4和分期。其他临床特征和血清肿瘤标志物对预后的影响不明显。结论：所有研究的肿瘤标志物（CEA、CA 19-9、CA 242、CA 72-4和hCG β）在胰腺癌中具有预后价值，并且hCG β、CA 72-4和分期是本研究中最强的独立预后因素。版权所有（C）2004 S. Karger AG，巴塞尔。
Objective: In pancreatic cancer, the extent of the spread of the disease is considered to be the strongest prognostic factor. In addition, tumor markers, particularly CA 199, may also provide prognostic information. In this study, we evaluated the prognostic value of serum tumor markers CEA, CA 19-9, CA 242, CA 72-4 and hCGbeta in pancreatic cancer. Methods: Preoperative serum samples were obtained from 160 patients with pancreatic cancer, including 10 with stage I, 25 with stage II, 24 with stage III and 101 patients with stage IV cancer. Quantitation of CEA, CA 19-9, CA 242, and CA 72-4 in serum was performed with commercial assays. HCGbeta was measured with an in-house immunofluorometric assay based on monoclonal antibodies specific for the free beta-subunit of hCG. Survival analysis was performed with univariate Kaplan-Meier life-tables and log-rank test, and with multivariate Cox regression analysis. Results: Of the tumor markers studied, CA 19-9 was most frequently elevated. Overall 2-year survival was 10%. Stage, tumor location and size, curative resection, and CEA, CA 72-4 and hCGbeta were all found to be prognostic factors (p < 0.026) in univariate analysis. In multivariate analysis, each marker had independent prognostic value (p < 0.011) when analyzed individually but adjusting for stage. When all the covariates were included in the same model, the strongest prognostic factor was hCGbeta followed by CA 72-4 and stage. The other clinical characteristics and serum tumor markers contributed insignificant prognostic information. Conclusions: All the tumor markers studied (CEA, CA 19-9, CA 242, CA 72-4, and hCGbeta) had prognostic value in pancreatic cancer, and hCGbeta, CA 72-4, and stage were the strongest independent prognostic factors in this study. Copyright (C) 2004 S. Karger AG, Basel.