血清CEA及CA19-9水平与胃癌预后的关系

Study of the prognostic significance of serum CEA and CA19-9 in gastric cancer

目的:探讨在胃癌高发地区胃癌患者血清癌胚抗原(carcino-embryonic antigen,CEA)和糖蛋白抗原(carbohydrate antigen 19-9,CA19-9)水平与预后的关系。方法:收集行胃癌手术治疗的98例患者临床资料,进行随访,采用电化学发光免疫法检测患者血清CEA和CA19-9水平。结果:肿瘤浸润深度(T3+T4)组CEA阳性患者比例高于(T1+T2)组(χ2=9.934,P=0.007),肿瘤高/中分化组CEA阳性患者比例高于低分化组(χ2=4.401,P=0.036),淋巴结转移N2组CA19-9阳性患者比例高于其它组(χ2=9.105,P=0.028);患者术后血清CEA水平为(2.33±1.90)ng/m L,低于术前的(10.01±28.32)ng/m L(Z=-5.468,P=0.000);血清CA19-9阳性组患者生存率低于CA19-9阴性组(χ2=5.017,P=0.017);术前血清CA19-9异常增高是胃癌术后患者长期生存的独立危险因素(HR:2.186,95%CI:1.095~4.366,P=0.027)。结论:血清CEA和CA19-9水平检测对胃癌的诊断以及评估预后具有应用价值,值得临床推广。

Objective： To investigate the prognostic significance of serum carcinoembryonic antigen （CEA） and carbohydrate antigen 19 -9 （CA19 -9） in patients with gastric cancer （GC） in areas of high GC incidence. Methods： The clinical data of 98 patients with GC who under- went surgical treatment were collected and follow - up was conducted. The serum level of CEA and CA19 -9 was detected by electro - chemilumi- nescence immunoassay. Results： The proportion of patients with positive CEA in the depth of tumor invasion （ T3 ＋ T4） group was higher than that of the depth of tumor invasion （ T1 ＋ T2 ） group （ x2 = 9. 934, P = 0. 007 ）. The proportion of patients with CEA positive in the tumor high/moder- ate differentiation group was higher than that of low differentiation group（ X2 =4. 401, P =0. 036）. The proportion of patients with CA19 -9 posi- tive in lymph node metastasis N2 group was higher than that in other groups （ X2 = 9. 105, P = 0. 028 ）. The postoperative serum C EA level was （2. 33 ± 1.90） ng/mL, lower than preoperative（ 10.01 ± 28.32） ng/mL（ Z = - 5. 468, P = 0. 000）. The survival rate of serum CA19 - 9 positive group was lower than that of CA19 - 9 negative group （ X2 = 5. 017, P = 0. 017）. Abnormal increase of pretreatment serum CA19 - 9 was an inde- pendent risk factor for postoperative long - term survival in patients with GC （ HR： 2.186, 95 % CI ： 1. 095 ~ 4. 366, P = 0. 027 ）. Conclusion ： The detection of serum CEA and CA19 -9 levels is of great value in the diagnosis of GC and in the evaluation of prognosis. It is worthy of clinical application.