摘要
目的:探讨联合检测术前、术后CEA、CA19-9、CA72-4等肿瘤标志物对不同分期胃癌根治术后复发的预测价值。方法:回顾性分析北京大学肿瘤医院2002年1月至2007年3月收治的564例胃癌患者的临床资料及血清肿瘤标志物情况。所有患者均未行新辅助治疗,术前、术后均联合检测CEA、CA19-9、CA72-4等肿瘤标志物。分析CEA、CA19-9、CA72-4等肿瘤标志物与胃癌复发的关系。结果:在Ⅰ、Ⅱ期胃癌患者中,CEA、CA19-9、CA72-4术前阳性的患者术后复发率分别为50.0%、24.1%、22.6%,而术后阳性的患者复发率分别为42.9%、21.7%、14.3%。在Ⅲ期胃癌患者中,CEA、CA19-9、CA72-4术前阳性的患者术后复发率分别为50.0%、55.2%、47.6%,而术后阳性的患者术后复发率分别为75.0%、66.7%、66.7%。多因素分析表明术前CEA增高是Ⅰ、Ⅱ期胃癌复发的独立影响因素,术后CA72-4增高是Ⅲ期胃癌复发的独立影响因素。结论:对于Ⅰ、Ⅱ期胃癌,术前CEA水平是预测复发较好的因子;对于Ⅲ期胃癌,术后CA72-4水平的预测性较好。
Objective： To investigate the predictive value of preoperative and postoperative serum tumor markers, namely, carcinoem- bryonic antigen （CEA）, carbohydrate antigen 19-9 （CA19-9）, and CA72-4, in the diagnosis of gastric cancer recurrence at different stag- es. Methods： Analysis was performed in 564 patients who underwent curative resection for gastric cancer between January 2002 and March 2007, received no chemotherapy at our hospital, and received complete follow-up according to the schedule determined pro- spectively. The values of CEA, CA19-9, and CA72-4 were evaluated before and after surgery. Results： in the pTNM-I and pTNM-II stage groups, patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels showed recurrence rates of 50.0%, 24.1%, and 22.6%, respectively. Similarly, the recurrence rates of patients with positive postoperative serum CEA, CA72-4, and CA29-9 levels were 42.9%, 22.7%, and 14.3%, respectively. Multivariate analysis showed that the positive preoperative serum CEA level could be an inde- pendent factor of recurrence. In the pTNM-III stage group, the recurrence rates of patients with positive preoperative serum CEA, CA29-9, and CA72-4 levels were 50.0%, 55.2%, and 47.6%, respectively. The recurrence rates of patients with positive postoperative se- rum CEA, CA29-9, and CA72-4 levels were 75.0%, 66.7%, and 66.7%, respectively. Multivariate analysis showed that high postoperative serum CA72-4 levels could be an independent factor of gastric cancer recurrence. Conclusion： Serum tumor markers exhibited differ- ent predictive values in different pTNM stages. Preoperative CEA level could be used to predict recurrence in patients with pTNM-I and pTNM-II stages of gastric cancer. Moreover, postoperative CA72-4 level could be used to predict recurrence in patients with pTNM-III stage gastric cancer.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2017年第7期324-330,共7页
Chinese Journal of Clinical Oncology
基金
北京市卫生系统215高技术人才项目(编号:2013-3-085)资助
关键词
胃癌
肿瘤标志物
术后复发
gastric cancer, serum tumor marker, postoperative recurrence
