肿瘤标记物CA19-9、CEA对胃癌转移和预后预测价值的分析

Significance of tumor markers CA19-9 and CEA for predicting metastasis and prognosis of gastric cancer

目的探讨肿瘤标记物CA19-9、CEA与胃癌生物学特性的关系,及其对判断胃癌的转移及预后的价值。方法回顾性分析我院2003年收治的248例胃癌患者的病例资料。采用单因素法分析血清CA19-9浓度、血清CEA浓度与胃癌病理生物学特性的关系,ROC曲线分析血清CA19-9、CEA浓度对胃癌转移的预测价值,Kap lain-M e ier法分析血清CA19-9、CEA浓度与Ⅲ~Ⅳ期胃癌预后的关系。结果单因素分析显示血清CA19-9浓度升高与胃癌的浸润深度、淋巴结转移、肿瘤大小、周围脏器受累有相关性,血清CEA浓度升高与胃癌的浸润深度、淋巴结转移、肝转移、腹膜转移、肿瘤大小、周围脏器受累有相关性;ROC曲线显示血清CA19-9浓度对胃癌淋巴结转移的预测准确率较高,血清CEA浓度对胃癌淋巴结转移、肝转移、周围脏器受累的预测准确率较高。在同期别胃癌中（Ⅲ-Ⅳ期）血清CA19-9、CEA浓度阳性组与阴性组预后有明显差别。结论血清CA19-9、CEA浓度升高是胃癌的晚期事件,且对判断胃癌的转移及预后有一定的价值。

Objective To investigate the relationships between tumor marker CA19-9,CEA and biological characteristics of gastric cancer,and their value for predicting metastasis and prognosis of gastric cancer.Methods A retrospective analysis of 248 cases with gastric cancer which were treated in our hospital in 2003 was conducted.Univariate analysis was used to investigate the relationships between serum CA19-9 level,serum CEA level and biological characteristics of gastric cancer.Serum CA19-9 and CEA levels were used to predict metastasis in gastric cancer by ROC analysis.Kaplain-Meier method was used to analyse the relationship between serum CA19-9 level,serum CEA level and prognosis of gastric cancer.Results Univariate analysis showed that factors correrlated with elevated serum CA19-9 level were depth of infiltration,lymphatic metastasis,size of tumor,surrounding organs to be involved.Factors correrlated with elevated serum CEA level were depth of infiltration,lymphatic metastasis,liver metastasis,peritoneal metastasis,size of tumor,and surrounding organs to be involved.ROC analysis indicated that elevated serum levels of CA19-9 were of some value for predicting lymphatic metastasis of gastric cancer,and elevated serum levels of CEA were of some value for predicting lymphatic metastasis,he-patic metastasis of gastric cancer,surrounding organs to be involved.Patients at the same disease stage（stageⅢ-Ⅳ）with elevated serum levels of CA19-9 and CEA had a significantly worse prognosis than patients with normal serum levels of CA19-9 and CEA.Conclusion Elavated serum CA19-9 and CEA levels are late events of gastric cancer,and of some value for predicting metastasis and prognosis of gastric cancer.