血清HIF-1α、VEGF-A、CEA和CA19-9表达水平对胃癌根治术后患者复发转移的预测研究

The prediction of HIF-1α, VEGF-A, CEA and CA19-9 serum levels for recurrence or metastasis in gastric cancer patients after radical surgery

目的:探讨胃癌根治术后患者血清HIF-1α、VEGF-A、CEA和CA19-9表达水平与胃癌临床病理特征、复发转移的关系。方法:采用回顾性的方法,对2010年1月至2012年9月于我院行胃癌根治术患者病历进行抽取,共计76例患者。对患者辅助化疗前后、随访截止前最近一次复诊时/复发转移时血清HIF-1α、VEGF-A、CEA和CA19-9的浓度进行整理与分析。结果:76例患者辅助化疗前后血清HIF-1α、VEGF-A、CEA和CA19-9表达水平之间的差异无统计学意义(P>0.05)。35例复发转移患者复发转移时血清HIF-1α、CEA浓度较辅助化疗前升高,差异有统计学意义(P<0.05)。35例患者复发转移时血清HIF-1α、CEA浓度较41例未复发转移患者随访截止前最近一次复诊时升高,差异有统计学意义(P<0.05)。亚组分析示31例血清CEA浓度维持在正常水平的患者,12例复发转移患者的血清HIF-1α浓度较19例未复发转移患者明显升高(P=0.022)。结论:胃癌根治术后患者复发转移时血清HIF-1α、CEA浓度升高;CEA浓度在正常范围内的患者,复发转移时血清HIF-1α浓度升高,提示根治术后患者血清HIF-1α浓度的动态升高可能预示胃癌复发转移。

Objective： To explore the corre1αtion among the serum concentrations of HIF-1α, VEGF-A, CEA, CA19-9, the patients＇ clinicopathological features, recurrence or metastasis in gastric cancer patients after curative resection. Methods： Using retrospective method, a total of 76 cases of gastric cancer patients after radical surgery from January 2010 to September 2012 in our department were extracted. The serum concentrations of HIF-1α, VEGF-A, CEA and CA19-9 were analyzed before and after adjuvant chemotherapy, at the 1αst visit before follow-up deadline/the occurrence of recurrence or metastasis. Results： There were no significant differences in the concentrations of HIF-1α, VEGF-A, CEA and CA19-9 before and after adjuvant chemotherapy in 76 patients （P 〉 0.05）. The concentrations of HIF-1α and CEA of 35 gastric cancer patients increased significantly after recurrence or metastasis compared with those before adjuvant chemotherapy （P 〈 0.05）. The concentrations of HIF-1α and CEA of 35 gastric cancer patients with recurrence or metastasis was significantly higer than those of 41 patients without recurrence or metastasis at the 1αst visit before follow-up deadline （P 〈 0.05）. The subgroup analysis showed that among 31 patients with normal CEA level, serum HIF-1α levels of with 12 patients recurrence or metastasis was significantly higher than those of 19 patients without recurrence or metastasis （P = 0.022）. Conclusion： The serum levels of HIF-1α and CEA of gastric cancer patients increased after recurrence or metastasis. For the patients with normal CEA level, the serum level of HIF-1α increased after recurrence or metastasis, which indicated that the increase of HIF-1α would predict the patients＇ recurrence or metastasis in gastric cancer.