Clinical significance of CA125 and CA72-4 in gastric cancer with peritoneal dissemination
Clinical significance of CA125 and CA72-4 in gastric cancer with peritoneal dissemination
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DOI：
10.1007/s10120-011-0091-8
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发表时间：
2012-04-01
期刊：
影响因子：
7.4
通讯作者：
Kitayama, Joji
中科院分区：
文献类型：
--
作者：
Emoto, Shigenobu;Ishigami, Hironori;Kitayama, Joji
血清肿瘤标志物已被证明与晚期胃癌患者的临床状态相关。然而，各肿瘤标志物在腹膜播散患者中的临床意义尚未得到充分验证。对102例接受静脉和腹腔联合化疗的腹膜播散患者定期检测癌胚抗原（CEA）、糖类抗原（CA）19-9、CA125和CA72-4 4种血清标志物。分析诊断时和治疗后的初始值与临床病理因素、化疗反应和总生存率的关系。初始诊断时CEA、CA19-9、CA125和CA72-4对腹膜转移的敏感性分别为19%、36%、46%和45%。 CA125水平与腹膜播散程度和是否存在恶性腹水显着相关。卵巢转移患者的 CA72-4 水平显着升高。 CA125水平升高的患者的中位生存时间显着短于CA125水平正常的患者（36.7个月与16.6个月，p < 0.001）。多变量分析显示腹膜转移程度和CA125水平升高是独立的预后因素。 3个疗程化疗后CA125水平正常化与腹水减少和生存率提高相关。血清CA125和CA72-4是临床上有用的标志物，可用于诊断、评估化疗效果和预测腹膜播散患者的预后。从学术角度来看，对于可能发生腹膜播散的胃癌患者，定期测量这些标志物是必要的。
Serum tumor markers have been shown to correlate with the clinical status of patients with advanced gastric cancer. However, the clinical significance of each tumor marker in patients with peritoneal dissemination has not been fully verified.Four serum markers, carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA125, and CA72-4, were periodically measured in 102 patients with peritoneal dissemination who received combination intravenous and intraperitoneal chemotherapy. The initial values at diagnosis and after treatment were analyzed in association with clinicopathological factors, response to chemotherapy, and overall survival.The sensitivities of CEA, CA19-9, CA125, and CA72-4 for peritoneal metastasis at the initial diagnosis were 19, 36, 46, and 45%, respectively. The CA125 level was significantly correlated with the degree of peritoneal dissemination and the existence of malignant ascites. Patients with ovarian metastasis showed significantly higher levels of CA72-4. The median survival time of patients with an elevated CA125 level was significantly shorter than that of patients with a normal CA125 level (36.7 vs. 16.6 months, p < 0.001). Multivariate analysis showed that the degree of peritoneal metastasis and an elevated CA125 level were independent prognostic factors. Normalization of the CA125 level after 3 courses of chemotherapy was correlated with reduced ascites and improved survival.Serum CA125 and CA72-4 are clinically useful markers in diagnosis, evaluating the efficacy of chemotherapy, and predicting the prognosis of patients with peritoneal dissemination. From an academic point of view, periodic measurements of these markers are warranted in gastric cancer patients with possible peritoneal dissemination.