肿瘤标志物在腹膜假黏液瘤复发患者诊治过程中的应用价值研究

Values of tumor markers in the diagnosis and treatment of recurrent pseudomyxoma peritonei

目的:在腹膜假黏液瘤(PMP)复发患者中,评价肿瘤标志物癌胚抗原(CEA)、CA199、CA125和CA724的临床应用价值。方法:对我院2008年1月至2012年12月收治并行肿瘤细胞减灭术(CRS)联合腹腔热灌注化疗(HIPEC)治疗的PMP复发患者进行回顾性调查。入选具有完整术前和术后肿瘤标志物检测资料的患者,其中CEA组、CA199组和CA125组各36例,CA724组27例。结果:CEA、CA199、CA125和CA724诊断敏感度分别为88.9%、63.9%、69.4%和96.2%,CEA和CA724显著高于CA199和CA125(P<0.05)。相关性分析显示,CEA(r=0.579,P<0.001),CA724(r=0.504,P=0.007),CA199(r=0.444,P=0.007)与腹膜种植癌指数(PCI)具有显著相关性;CA125(r=0.103,P=0.551)与PCI无显著相关性。术后CEA、CA199、CA125和CA724组的降低率分别为97.2%、77.8%、80.5%和100.0%。在术后各肿瘤标志物水平降低的患者中,CEA、CA199、CA125和CA724组的水平降低率分别是(56.9±22.5)%、(45.0±22.3)%、(54.9±22.1)%和(59.4±12.4)%。结论:PMP复发患者中应首选CA724和CEA作为PMP诊断和疗效监测的肿瘤标志物。

Objective To explore the clinical values of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125),and carbohydrate antigen 724(CA724)in patients with recurrent pseudomyxoma peritonei(PMP).Methods A retrospective study was conducted in patients with recurrent PMP treated with cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)in our hospital during the period of January 2008 to December 2012.The patients with complete pre-and postoperative measurement of tumor markers were assigned to CEA(36 patients),CA199(36 patients),CA125(36 patients),or CA724 group(27 patients).Results The diagnostic sensitivity was 88.9% for CEA,63.9% for CA19.9,69.4% for CA125,and 96.2% for CA724.The diagnostic sensitivity of CEA or CA724 was significantly higher than that of CA199 or CA125(P < 0.05).CEA(r = 0.579,P < 0.001),CA724(r = 0.504,P = 0.007),and CA199(r = 0.444,P = 0.007)were significantly related with peritoneal cancer index(PCI),but CA125(r = 0.103,P = 0.551)was not significantly associated with PCI(P > 0.05).After surgery,the rate of a decrease in CEA,CA199,CA125,and CA724 was 97.2%,77.8%,80.5%,and 100.0%,respectively.In patients with a decline in postoperative levels of tumor markers,the rate was(56.9 ± 22.5)% for CEA,(45.0 ± 22.3)% for CA199,(54.9 ± 22.1)% for CA125,and(59.4 ± 12.4)% for CA724.Conclusions Both CEA and CA724 can be used as the primary tumor markers for diagnosing the recurrence of pseudomyxoma peritonei and monitoring the efficacy of treatment.