The prognostic significance of gastric juice CA 19-9 and CEA levels in gastric carcinoma patients

AIM: The usefulness of gastric juice CA 19-9 and carcinoembryonic antigen (CEA) levels in the diagnosis of gastric carcinoma is controversial. There is only one study related with their prognostic value. In this study the clinical significance of gastric juice CA 19-9 and CEA levels in patients with gastric carcinoma was investigated. METHODS: Preoperative serum and gastric juice CA 19-9 and CEA concentrations were measured in 139 patients with gastric carcinoma, 54 patients with benign gastroduodenal disease and as the 'healthy' control group 46 patients with inguinal hernia and with no other pathology. RESULTS: In all groups the mean gastric juice levels of CA 19-9 and CEA were significantly higher than the serum levels. The gastric juice CA 19-9 levels were not different between groups. Gastric juice CEA levels of the gastric carcinoma group were significantly higher than those of the benign gastroduodenal disease group (P=0.007) and had a tendency to increase when compared to those of the control group (P=0.064) whereas there was no significant difference between the benign gastroduodenal disease and the control group. The cut-off values of gastric juice CA 19-9 and CEA were 440U/ml and 320ng/ml and the positivity ratios of these markers in gastric carcinoma patients were 16.5 and 27.3%, respectively. There was no significant relationship between the histopathological features and the gastric juice CA 19-9 or CEA positivities. Neither univariate analysis nor the multivariate Cox proportional hazards model analysis showed prognostic value for gastric juice CA 19-9 and CEA positivities. CONCLUSIONS: The gastric juice CA 19-9 and CEA levels have no diagnostic and prognostic significance in gastric carcinoma patients.     

Significance of serum and tissue carcinoembryonic antigen for the prognosis of gastric carcinoma patients

BACKGROUND AND OBJECTIVES: Carcinoembryonic antigen (CEA) has been widely accepted as a tumor marker useful in the diagnosis and management of colorectal carcinoma. When CEA levels are positive in patients with gastric carcinoma, they could be useful prognostic indicators. The value of CEA as a tumor marker for gastric carcinoma, however, remains a matter of controversy. The purpose of this study was to determine whether preoperative serum CEA value and tissue CEA staining are useful prognostic indicators for gastric carcinoma. METHODS: We measured preoperative serum CEA levels by radioimmunoassay and stained tissue CEA production by tumor cells from gastric carcinomas using immunohistochemical staining in patients with gastric carcinoma. RESULTS: The patients with preoperative serum CEA levels >10.0 ng/mL had a more prominent serosal invasion, much more lymph node involvement, more advanced stage and more poorly differentiated than did the patients with preoperative serum CEA levels <5.0 ng/mL. The survival rate of patients with serum CEA levels >10.0 ng/mL was poorer than those of patients with serum CEA levels between 5.0 and 10.0 ng/mL, and those of patients with serum CEA levels <5.0 ng/mL (P < 0.05). The preoperative serum CEA levels and tumor CEA-positivity were correlated (P < 0.05). In patients with lymph node metastases, the CEA-positivity (78.0%) was higher than in patients without lymph node metastasis (63.2%) (P < 0.05). A correlation was also found between the depth of tumor invasion and tissue CEA-positivity (P < 0.001). The postoperative survival rate was significantly better in the CEA-negative staining group (78.0%) than in the CEA-positive staining group (60.0%). CONCLUSIONS: These data suggest that preoperative serum CEA levels and staining for CEA in gastric carcinoma tissue sections may have a predictive value in determining prognostic information for patients with resectable gastric carcinoma.     

Value of gastric juice carcinoembryonic antigen in identifying high-risk patients for gastric cancer

The relationship of the level of carcinoembryonic antigen (CEA) in the gastric juice to the extent of intestinal metaplasia and gastric cancer, and clinical values of gastric CEA for identifying high-risk patients for gastric cancer were examined. A significant correlation was found between the levels of gastric CEA and the distribution of intestinal metaplasia. Studies were made by the endoscopic Congo red-methylene blue test developed at our hospital. Gastric CEA levels were significantly higher in patients with localized and diffuse intestinal metaplasia than in those with no intestinal metaplasia. The mean levels of gastric CEA in patients with well-differentiated adenocarcinomas were significantly higher than in those with diffuse intestinal metaplasia. They were also significantly higher in patients with poorly differentiated adenocarcinomas than in patients with no intestinal metaplasia, but not significantly higher than in those with diffuse intestinal metaplasia. Endoscopic follow-up examinations show that gastric cancer was detected in only 1 patient with a gastric CEA level of 10 ng/ml or more, but in none of those with gastric CEA of less than 10 ng/ml, during the average observation period of 4.3 years. These results indicate that gastric CEA is produced both by intestinal metaplasia and well- and poorly differentiated adenocarcinomas, and that gastric CEA is useful in identifying high-risk patients for gastric cancer.     

Serum beta 2--microglobulin and carcinoembryonic antigen in patients with gastric disorders

A comparative study of carcinoembryonic antigen (CEA) and beta 2-microglobulin in serum was made by radioimmunoassay in 121 patients with gastric disease. There was no statistical difference in serum CEA and beta 2-microglobulin in patients with benign gastric disease, early gastric carcinoma, and advanced gastric carcinoma. However, CEA levels in patients with advanced gastric carcinoma were higher than those in benign gastric disease and in early gastric carcinoma but beta 2-microglobulin did not show and differences. Furthermore, after total removal of the tumor, the elevated CEA levels decreased but beta 2-microglobulin remained unchanged. We concluded that CEA appeared to predict tumor behavior more accurately in patients with gastric carcinoma than beta 2-microglobulin.     

The prognostic significance of preoperative serum CA 19-9 in patients with resectable gastric carcinoma: comparison with CEA

BACKGROUND AND OBJECTIVES: In this study, the prognostic value of pre-operative serum levels of tumor markers CA 19-9 and carcinoembryonic antigen (CEA) in gastric carcinoma which has been a controversial matter was investigated. METHODS: Preoperative serum CA 19-9 (cut-off value 37 U/ml) and CEA (cut-off value 5 ng/ml) levels were measured in 168 patients with resectable gastric carcinoma. The correlation between tumor marker levels and clinicopathological features and overall survival was studied. RESULTS: CA 19-9 and CEA positivity rates were 31.5 and 17.8% respectively. In CA 19-9 positive patients, the ratio of males, tumors exceeding subserosa and advanced stage tumors (stages III and IV) was significantly higher (P = 0.052, P = 0.0005 and P= 0.029, respectively). A weak correlation was found with CA 19-9 positivity and tumor location; however, no correlation existed between CA 19-9 positivity and age, tumor size, histologic type, lymph node, hepatic and peritoneal metastasis. The proportion of tumors extending beyond subserosa and with lymph node metastasis was significantly higher in CEA positive patients (P = 0.011 and P = 0.045, respectively). No correlation was found between CEA positivity and gender, age, tumor location, tumor size, and hepatic and peritoneal metastasis; however, a weak correlation existed between CEA positivity and histologic type and tumor stage. Overall survival was significantly poorer in CA 19-9 and CEA positive patients (log-rank test, P = 0.014, P = 0.003, respectively). However, the Cox proportional hazards regression analysis did not show independent prognostic value for both tumor markers. CONCLUSIONS: In resectable gastric carcinoma, preoperative serum CA 19-9 and CEA levels may indicate stage of the disease, but neither has an independent prognostic value.     

CD147、CEA 在胃癌组织中的表达及预后价值

目的：研究胃癌组织中 CD147、CEA 的表达及其与胃癌患者临床病理参数和总体生存率之间的关系。方法：应用免疫组织化学（SP）法检测胃癌组织标本及癌旁胃组织中 CD147、CEA 的表达情况,并随访患者进行生存分析。结果：胃癌组织中 CD147、CEA 的阳性表达率均显著高于癌旁组织（P ＜0．05）。CD147、CEA 在胃癌中的表达均与胃癌的浸润深度、淋巴结转移和 TNM分期显著相关（P ＜0．05）。相关性分析发现, CD147与 CEA 在胃癌组织中的表达呈正相关（r ＝0．292,P ＝0．020）。经 Kaplan －Meier 生存分析显示, CD147、CEA 蛋白表达阳性的患者生存率均明显低于表达阴性组患者（P ＜0．05）。单因素分析发现肿瘤浸润深度、TNM分期、淋巴结转移、CD147、CEA 均为影响胃癌患者预后的重要因素;Cox 风险模型多因素分析发现肿瘤的 TNM分期、淋巴结转移、CD147、CEA 是影响胃癌预后的独立危险因素。结论：CD147和 CEA 的表达与胃癌的浸润和转移密切相关,两者在胃癌中的表达具有协同作用,它们可协同促进胃癌的侵袭和转移。CD147和 CEA 是胃癌预后的独立危险因素,可成为胃癌预后的新型标志物和治疗的新靶点。     

CEA and CA 19.9 in gastric juice and serum: an aid in the diagnosis of gastric carcinoma?

The aim of this study was to examine the effect of pH on the measurement of carcino-embryonic antigen (CEA), and to assess the efficacy of a combination of serum and gastric juice levels of CEA and Carbohydrate Antigen 19.9 (CA 19.9) in the diagnosis of gastric carcinoma. An initial experiment was performed to determine the effect of pH on the CEA assay. There was a direct linear relationship between pH and the concentration of CEA measured by the assay, such that as hydrogen ion concentration increased, the apparent concentration fell. The correct value was measured at pH 7. Seventy-six normal patients with non-malignant upper gastro-intestinal disorders, and 49 patients with gastric carcinoma were studied, two of which were 'early' gastric carcinomas. All patients underwent upper GI endoscopy, and at this examination blood and gastric juice were taken for analysis. A 'normal range' was constructed as a 95% confidence interval for each of the antigens in serum and gastric juice. The highest sensitivity was achieved using a combination of the two antigens, CEA and CA 19.9 in gastric juice and serum, with a sensitivity of 95.7% and a specificity of 50%. This combination of assays could have value in a screening programme for gastric cancer.     

胃癌患者血清肿瘤标志物的特点及临床意义

目的分析胃癌患者血清多种肿瘤标志物的特点,为临床提供胃癌筛查、诊断及动态监测指标。方法采用C-12多种肿瘤标志物蛋白芯片检测系统对129例胃癌术前患者、45例胃癌术后患者、76例胃部良性疾病患者及189例正常体检者的血清进行12种肿瘤标志物检测。并对其进行统计分析。结果胃癌患者血清中CA199(28.7%),NSE(6.2%),CEA(21.7%),CA242(20.2%),HCG(22.5%),AFP(6.2%)及HGH(22.5%)单项指标检出阳性率均高于正常健康者及胃部良性疾病患者(P<0.05);而胃癌术后患者仅CA199(13.3%)和CEA(21.7%)高于正常健康者(P<0.05);胃癌患者血清CA199和CA242水平明显高于胃癌术后患者(P<0.05)。胃癌患者血清单一指标阳性检出率最高为CA199的达28.7%,而联合上述有统计学意义的7项指标阳性检出率高达53.5%,与正常健康者(20.3%),统计学上有显著性意义(P=0.000)。结论多种肿瘤标志物联合检测能提高胃癌患者的阳性检出率,并为胃癌患者治疗效果的动态分析提供客观依据。     

胃癌患者血清CA72-4、CEA及CA19-9水平及其与临床病理特征的相关性

目的:探讨血清CA72-4、CEA及CA19-9水平与胃癌患者病理特征的相关性。方法:选择2011年6月-2013年3月收治的86例胃癌患者,56例胃良性肿瘤患者,60例普通胃病患者,比较三组患者CA72-4、CA19-9和CEA水平;CA72-4、CA19-9和CEA单项检测及联合检测胃癌患者的阳性率;CA72-4、CA19-9和CEA水平与胃癌病理特征的关系。结果:胃癌组患者血清CA72-4、CA19-9和CEA水平均高于胃良性肿瘤组患者（P＜0.05),胃癌良性组患者均高于对照组（P＜0.05);三种胃癌肿瘤标志物中CA72-4诊断胃癌的阳性率最高,肿瘤3项标志物的阳性检测率要显著高于单项CA72-4、CA19-9、CEA的阳性检出率（P＜0.05）;肿瘤越大、TNM分期越高,CA72-4、CA19-9和CEA水平越高。结论:采用CA72-4、CA19-9和CEA联合检测是诊断胃癌比较理想的组合。CA72-4、CA19-9和CEA水平的变化可以反应胃癌患者的病理特征。     

血清肿瘤标志物在胃癌诊断中的价值

目的：探讨三项肿瘤标记物联合检测对胃癌诊断的价值。方法：采用电化学发光分析仪测定450例胃癌患者（胃癌组）、30例胃良性病变患者（对照组）的血清肿瘤标志物[癌胚抗原（CEA）,糖类抗原（CAl99,CA724）]。分析单项肿瘤标志物和三项肿瘤标志物联合检测在胃癌诊断上的敏感性、特异性、准确性、阳性预测值、阴性预测值、阳性似然比、阴性似然比、比数比。结果：胃癌组单项肿瘤标志物水平均高于对照组,差异非常显著（P〈0．01）。胃癌组的肿瘤标志物联合检测敏感性、准确性高于单项检测,差异非常显著（P〈0．01）。结论：CEA、CAl99、CA724单项检测对胃癌诊断有一定意义,联合检测更能提高诊断敏感性、准确性。     

CA 72-4 measurement of tumor-associated glycoprotein 72 (TAG-72) as a serum marker in the management of gastric carcinoma.

The presence of three distinct serum markers of carcinoma, tumor-associated glycoprotein 72 (TAG-72; as measured by the CA 72-4 assay), CA 19-9, and carcinoembryonic antigen (CEA), was evaluated in 194 patients diagnosed with either malignant (n = 94) or benign (n = 100) gastric disease. Of the 94 patients diagnosed with gastric carcinoma, the percentage of patients whose serum samples were positive for TAG-72, CA 19-9, or CEA was 42.6, 31.9, and 20.2%, respectively. Furthermore, fewer false positive samples were observed for TAG-72 than either CA 19-9 or CEA. The analysis of serum TAG-72, CA 19-9, and CEA levels in patients diagnosed with early (stage I and II) versus advanced (stage III and IV) disease revealed a significantly higher level of TAG-72 and CA 19-9 in the serum of patients with advanced stage gastric carcinoma. The serum samples were also analyzed to determine whether any advantage might be gained by simultaneously measuring two or more of the tumor markers. The data clearly indicate that the measurement of TAG-72 with CA 19-9 significantly increased the percentage of gastric carcinoma patients with positive serum levels of either antigen. This advantage was achieved with no significant increase in the number of false positives. Twenty-one patients were followed postsurgically for up to 3 years to determine whether the appearance or reappearance of TAG-72, CA 19-9, or CEA accurately predicted disease recurrence. Positive serum TAG-72 levels correlated with disease recurrence in 7 of 10 patients, compared with 5 and 2 patients for CA 19-9 and CEA, respectively. The findings suggest that serum TAG-72 as measured by the CA 72-4 assay may be a useful marker for late stage gastric carcinoma and its measurement alone or in combination with CA 19-9 may have utility in the clinical management of gastric carcinoma.     

Carcinoembryonic antigen in patients with gastric carcinoma

Carcinoembryonic antigen (CEA) was quantified pre- and post-operatively in plasma from 171 patients with gastric carcinoma. The pre-operative plasma concentration was above the normal reference value (3.5 micrograms/l) in 18% of the patients in stage I-III (pTNM) and in 57% of the patients in stage IV. Pre-operative concentrations above 10 micrograms/l indicated metastatic or inoperable disease. The concentrations were not different between the stages I, II and III. However, the pre-operative CEA concentrations were related to survival after potentially curative resection. At recurrence most of the patients had markedly increased CEA, often with increasing CEA in the months before clinical recurrence. Most of the patients clinically disease-free at the end of the follow-up period had a transitory or prolonged post-operative elevation of CEA. This made the post-operative evaluation of CEA difficult. Serial determination of CEA in the follow-up of gastric cancer patients therefore had little or no clinical value, whereas the pre-treatment levels were of clinical significance.     

Carcinoembryonic antigen and immunoglobin in gastric juice in the diagnosis of gastric cancer

Levels of carcinoembryonic antigen (CEA) and immunoglobin (Ig) in gastric juice of 93 patients with benign and malignant gastric diseases were assayed. The CEA level in gastric cancer patients (55.73 +/- 38.26 ng/ml) was obviously higher than that in peptic ulcer (15.51 +/- 12.09 ng/ml) and superficial gastritis (26.96 +/- 20.17 ng/ml). But no significant difference was found between the CEA levels of gastric cancer and chronic atrophic gastritis (48.66 +/- 31.87 ng/ml). Also, elevated CEA was closely correlated to intestinal metaplasia. The positive rate of Ig was significantly higher in gastric cancer (IgG greater than or equal to 185 ug/ml, IgA greater than or equal to 100 ug/ml) than in benign gastric diseases. Although no correlation is present in the CEA and Ig in gastric juice, the combination of these two methods could improve the diagnostic accuracy. We believe that the two assays are worthy for screening gastric cancer from patients with high risk, and for identifying precancerous lesions.     

胃癌患者血清血管内皮生长因子检测的临床意义

目的　探讨血清血管内皮生长因子 (s -VEGF)与胃癌临床病理特征的关联及作为胃癌早期诊断指标的可行性。方法　采用酶联免疫吸附法检测 31例胃癌患者术前及术后第一天s-VEGF水平 ,并与同期 13例慢性萎缩性胃炎患者对照。结果　胃癌患者s -VEGF高于对照组 (P <0 .0 5 ) ;s-VEGF随临床分期进展而升高 (P <0 .0 5 ) ;接受根治手术的患者术后较术前下降 (P <0 .0 5 ) ;接受姑息手术者下降不明显 (P >0 .0 5 )。结论　s -VEGF与胃癌的临床病理特征有关 ,术后s -VEGF仍显著增高者需要更积极的治疗。单一s-VEGF检测不能作为胃癌的早期诊断指标     

胃癌患者手术前后血清层粘连蛋白水平的变化及临床意义

 应用放射免疫技术测定了胃癌患者血清层粘连蛋白（LN）水平变化及切除肿瘤对其的影响。结果显示：胃癌患者血清LN水平明显高于对照组（P＜0.05）；进展期组高于早期组（P＜0.O5〕；手术切除肿瘤特别是行根治性切除术后，血清LN水平显著降低P＜O.05）。认为血清LN水平与肿瘤的浸润及转移过程密切相关；观察血清LN水平及其变化，对胃癌者的病情及预后判断有一定的参考价值。     

胃癌患者血清表皮生长因子测定的临床评价

目的　探讨胃癌患者血清表皮生长因子 (EGF)水平变化的临床价值。方法　采用放射免疫分析 (RIA)对46例胃癌患者进行测定EGF的含量。结果　胃癌患者血清EGF水平显著高于正常对照组 (P <0 .0 1)且中晚期胃癌组亦显著高于早期胃癌组 (P <0 .0 5 )。结论　胃癌患者检测EGF水平有助于判断胃癌的恶性程度及预后评价。     

血清CEA、CA19-9、CA724检测对老年胃癌病理、临床分期的意义

目的:探讨血清CEA、CA19-9、CA724对老年胃癌的临床应用价值.方法:采用ELISA方法对87例老年胃癌患者进行回顾性分析.结果:老年胃癌患者CEA、CA19-9、CA724阳性率分别为25%、21%、21%,联合检测阳性率为41%,其中TNM Ⅳ期患者CA19-9、CA724、联合检测阳性率明显高于TNM Ⅰ+Ⅱ期患者.TNM Ⅲ+Ⅳ期患者CA19-9、CA724检测值明显高于Ⅰ+Ⅱ期患者.CEA、CA19-9、CA724阳性率、其值大小与胃癌病理类型、分化无关.结论:CEA、CA19-9、CA724可用于老年胃癌的诊断、病情判断,联合检测可提高诊断效率,但早期诊断价值有限.