Peritoneal carcinoembryonic antigen level for predicting locoregional and distant spread of gastric cancer
Peritoneal carcinoembryonic antigen level for predicting locoregional and distant spread of gastric cancer
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DOI：
10.1007/s00595-005-3057-9
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发表时间：
2005-11-01
期刊：
影响因子：
2.5
通讯作者：
Çetin, A
中科院分区：
文献类型：
--
作者：
Çetin, B;Atalay, C;Çetin, A
目的。腹膜复发并不是胃癌手术后常见的死亡原因，即使是在进行根治性手术后也是如此。这表明腹膜腔内存在未被检测到的残留疾病。我们进行这项研究是为了确定腹膜和血清癌胚抗原（CEA）水平以及腹膜冲洗细胞学在预测胃癌局部和远处扩散中的价值。方法。我们通过测量腹膜 CEA (pCEA) 和血清 CEA (sCEA) 水平以及腹膜冲洗细胞学结果对 70 名连续胃癌患者进行了前瞻性评估，并研究了它们对组织病理学特性的影响。还在接受治疗的患者中评估了 pCEA 水平对无病生存期 (DFS) 和总生存期 (OS) 的影响。结果。 21 名患者 (30%) 的 sCEA 水平 > 10 ng/ml，25 名患者 (35.7%) 的 pCEA 水平 > 10 ng/g 蛋白质，26 名患者 (37.1%) 的细胞学结果呈阳性。肝转移（P = 0.034）或浆膜（P = 0.028）和腹膜（P = 0.026）受累患者的 pCEA 水平显着较高，而仅肝转移患者的 sCEA 水平显着较高（P = 0.04）。同样，细胞学阳性主要见于肝转移患者（P = 0.004）。 pCEA 水平显着影响 34 名以治疗为目的的患者的 DFS (P = 0.002) 和 OS (P = 0.01)。 结论 由于 pCEA 水平对于预测局部复发更有用，因此手术期间的测量可能有助于规划最合适的手术策略和辅助治疗。
Purpose. Peritoneal recurrence is not an uncommon cause of death after surgery for gastric cancer, even after surgery with curative intent. This indicates that there is undetected residual disease in the peritoneal cavity. We conducted this study to determine the value of peritoneal and serum carcinoembryonic antigen (CEA) levels and peritoneal washing cytology in predicting the locoregional and distant spread of gastric cancer.Methods. We prospectively evaluated 70 consecutive patients with gastric cancer by measuring peritoneal CEA (pCEA) and serum CEA (sCEA) levels and peritoneal washing cytology results, and studying their effect on the histopathologic properties. The effect of the pCEA level on disease-free survival (DFS) and overall survival (OS) was also evaluated in patients treated with curative intent.Results. Twenty-one (30%) patients had sCEA levels > 10 ng/ml, whereas 25 patients (35.7%) had pCEA levels > 10 ng/g protein and 26 patients (37.1%) had positive cytology. The pCEA levels were significantly higher in patients with hepatic metastases (P = 0.034), or serosal (P = 0.028), and peritoneal (P = 0.026) involvement, whereas the sCEA levels were significantly higher only in patients with hepatic metastases (P = 0.04). Similarly, positive cytology was mainly detected in patients with hepatic metastases (P = 0.004). The pCEA levels significantly affected DFS (P = 0.002) and OS (P = 0.01) in 34 patients treated with curative intent.Conclusion Since pCEA levels are more useful for predicting locoregional recurrence, their measurement during surgery may help plan the most appropriate surgical strategy and adjuvant therapy.