胃癌患者组织与血清CEA水平的关系及临床意义

Correlation and clinical significance of tissue and serum carcinoembryonic antigen levels in patients with gastric cancer

目的探讨可手术切除胃癌患者中组织与血清CEA表达的关系及临床意义。方法应用电化学发光法检测53例行胃癌根治术患者手术前后血清CEA、CA19-9水平,用免疫组织化学方法检测胃癌组织CEA表达情况,分析其表达相关性及与临床病理学参数的关系。结果胃癌组织中CEA阳性表达率为71.7%,血清CEA阳性表达率为20.8%,组织CEA表达强度与血清CEA水平呈正相关(r=0.319,P<0.05)。组织CEA表达水平与胃癌的分化程度、TNM分期相关(均P<0.05),而与年龄、性别、淋巴结转移无关(均P>0.05)。胃癌患者术前血清CA19-9阳性表达率为15.1%,血清CEA与CA19-9表达无相关性(P>0.05)。血清CEA和CA19-9表达水平与年龄、性别、分化程度、TNM分期、淋巴结转移无关(均P>0.05)。较术前相比,患者术后血清CEA、CA19-9均下降,差异有统计学意义(均P<0.05)。结论胃癌组织CEA与血清CEA表达呈正相关,两者联合使用可能更有助于评估可手术切除胃癌患者的预后情况。

Objective To investigate the correlation between tissue and serum carcinoembryonic antigen(CEA)expression in patients with resectable gastric cancer and their clinical significance.Methods Electrochemical luminescence assay was used to detect the levels of serum CEA and CA19-9 expression in 53 patients with gastric cancer preoperatively and postoperatively.Immunohistological method was used to detect tissue CEA expression.The correlation between serum CEA,CA19-9 and tissue CEA,and the association with clinicopathologic parameters were analyzed.Results The positive expression rates of tissue CEA and serum CEA in gastric cancer were 71.7%and 20.8%respectively.The expression intensity of tissue CEA was positively correlated with the level of serum CEA expression(r=0.319,P<0.05).The expression level of tissue CEA was significantly correlated with the degree of tumor differentiation and TNM staging of gastric cancer(all P<0.05),but not with the age,gender and lymphatic metastasis(all P>0.05).The positive expression rates of serum CA19-9 in gastric carcinoma was 15.1%without correlation with serum CEA(P>0.05).The levels of serum CEA and CA19-9 were not associated with age,gender,differentiation,TNM staging and lymphatic metastasis(all P>0.05).The levels of serum CEA and CA19-9 after operation were both significantly lower than those before operation(all P<0.05).Conclusion The expression of CEA in gastric cancer tissues was positively correlated with serum CEA,and the combination could be more useful to evaluate the prognosis of patients with resectable gastric cancer.