多种肿瘤标志物与胃癌进展及预后的关系

Relationship Between Tumor Markers and Clinical Outcomes in Gastric Cancer

目的:研究血清肿瘤标志物与胃癌临床转归的关系。方法:检测166例胃癌患者术前血清标志物水平,术后随访,获得76例患者完整预后信息。分析肿瘤标志物与肿瘤浸润深度、临床分期、淋巴结转移及预后的关系。结果:CEA阳性率与肿瘤浸润深度和临床分期显著相关,CA19-9与临床分期相关(P<0.05)。CA19-9、CEA、CA125预测胃癌患者不良预后的敏感性和特异度都高于术前诊断。3项标志物同时升高患者中位生存时间3.0个月,两项同时升高者11.0个月,只有一项标志物升高的患者19.0个月(P<0.01)。多因素生存分析提示CA19-9和临床分期为独立预后因素(P<0.05)。CA19-9升高倍数与生存时间呈中度负相关(r=-0.466,P<0.01)。结论:胃癌患者术前血清CA19-9、CEA、CA125升高可预测不良预后,CA19-9为预测预后的独立因素。

Objective： To study the relationship between serum tumor markers and the clinical outcomes in gastric cancer. Methods： Preoperative serum tumor markers were determined in 166 gastric cancer patients, who were followed after curative gastrectomy. The association between tumor markers and tumor invasion depth, clinical stage, lymph node metastasis was analyzed in 166 patients. And among the 76 patients with complete clinical outcome information, the correlation between tumor marker levels and survival status was analyzed. Results： Carcinoembryonic antigen （CEA） positive rate was significantly correlated with serosal invasion of the stomach and clinical stage, and carbohydrate antigen 19 9 （CA19-9） related to the clinical stage （P〈0.05）. CA19-9, CEA and cancer antigen 125 （CA125） were more sensitive and specific in predicting worse prognosis than in diagnosis. Patients with more markers positive had shorter survival time, as 19.0, 11.0 and 3.0 months of median survival time for one, two, and three markers positive, respectively （P〈0.01）. Multivariate analysis showed that CA19 9 and clinical stage were independent prognostic factors （P〈0.05）. The degree of the CA19-9 elevation had a modest negative correla-tion with survival （r=-0. 466,P〈0.01）. Conclusion. Preoperative serum CEA, CA19-9 and CA125 levels indicate poor prognosis in gastric cancer, and CA19-9 is an independent negative prognostic factor.