94例胃癌癌胚抗原的分析在诊断和预后中的意义

ANALYSIS OF CARCINO-EMBRYONIC ANTIGEN IN 94 PATIENTS WITH GASTRIC CARCINOMA AND ITS SIGNIFICANCE IN DIAGNOSIS AND PROGNOSIS

观察９４例胃癌病人手术切除的肿瘤组织癌胚抗原（ＣＥＡ）免疫酶标的表达，检测４５例胃癌病人术前血清ＣＥＡ浓度，并随访２１例术后的胃癌病人。结果提示：血清ＣＥＡ水平与肿瘤生长部位及浸润深度关系不大，但与肿瘤大小、组织类型及血管和淋巴管是否累及有关。４５例胃癌病人同时进行组织及血清ＣＥＡ的比较性研究，发现免疫组化ＣＥＡ表达的阳性率要比血清ＣＥＡ检测的阳性率高得多（Ｐ＜０．０１）。２１例胃癌病人的随访，早期胃癌５年生存率为８３．３％（５／６），晚期胃癌为３３．３％（５／１５），血清ＣＥＡ浓度轻度升高或免疫酶标弱阳性预后较好；血清浓度明显升高的２例，于５年内死亡；肿瘤组织内ＣＥＡ呈强阳性者，术后生存率低，免疫组化强度与肿瘤预后呈明显正相关（Ｐ＜０．０５）。通过两种方法比较研究提示：血清浓度明显升高特别是组织内ＣＥＡ表达强阳性，具有估计预后的意义；且ＣＥＡ免疫组化显色比血清检测更为敏感（Ｐ＜０．０１），可作为推测胃癌预后的一项指标。

The expression of CEA was examined immunohistochemically in surgical specimens of 94 gastric carcinoma (GC) patients, and preoperative serum CEA levels of 45 patients were detected by radioimmunoassay (RIA). The results of both methods were compared to evaluate CEA changes on diagnosis and prognosis of GC. The positive rate of CEA expression in cancer tissue was much higher than that in patient serum detected by RIA (P<0.01). There is no correlation among the serum CEA and the site of tumor growth and the depth of GC infiltration, but it is related to the size of the tumor, the histologic type and whether the lymphatics and blood vessels are involved. A positive correlation was found between the intensity of CEA immunohistochemical staining and the patients’prognosis (P<0. 05).