Adjuvant chemotherapy,p53,carcinoembryonic antigen expression and prognosis after D2 gastrectomy for gastric adenocarcinoma

AIM:To investigate adjuvant chemotherapy,p53 and carcinoembryonic antigen(CEA)expression and prognosis after D2 gastrectomy for stageⅡ/Ⅲgastric adenocarcinoma.METHODS:A total of 286 patients with stageⅡorⅢgastric adenocarcinoma who underwent D2 radical gastrectomy between May 2007 and December 2010 were enrolled into this study.One hundred and sixty-nine of these patients received surgery plus adjuvant chemotherapy,and 117 patients received surgery alone.Tumor expression of p53 and CEA proteins in all patients was evaluated immunohistochemically and correlated with clinicopathological parameters.The Kaplan-Meier curves for overall survival(OS)and disease-free survival(DFS)with log-rank testing were used to compare the survival difference.A Cox proportional hazard regression model was used for multivariate analysis.RESULTS:Patients with adjuvant chemotherapy had a significantly better median OS(50.87 mo vs 30.73 mo,P=0.000)and median DFS(36.30 mo vs 25.60 mo,P=0.001)than patients with surgery alone in the entire cohort.Consistent results with the entire cohort were found in stageⅡ(P=0.006 and P=0.047),stageⅢ(P=0.005 and P=0.030),and stageⅢB/ⅢC patients(P=0.000 and P=0.001).The median OS and DFS advantages were confirmed by multivariate analysis(P=0.000 and P=0.008)and maintained when the analyses were restricted to fluoropyrimidine monotherapy(P=0.003 and P=0.001)and fluoropyrimidine plus platinum regimen(P=0.001 and P=0.007),however,not the fluoropyrimidine plus taxane(P=0.198 and P=0.777)or platinum plus taxane(P=0.666 and P=0.687)regimens.Median OS and median DFS did not differ significantly between the patients with p53(+)and p53(-)tumors(P=0.608 and P=0.064),or between patients with CEA(+)and CEA(-)tumors(P=0.052 and P=0.989),which were maintained when the analyses were restricted to surgery alone(p53:P=0.864 and P=0.431;CEA:P=0.142 and P=0.948),adjuvant chemotherapy(p53:P=0.802 and P=0.091;CEA:P=0.223 and P=0.946)and even different chemotherapy regimens(P>0.05).CONCLUSION:Patients after D2 gastrectomy for stageⅡ/Ⅲgastric adenocarcinoma had significantly better survival after fluoropyrimidine monotherapy and fluoropyrimidine plus platinum.p53 and CEA were not prognostic.     

Detection of carcinoembryonic antigen mRNA in peritoneal washes from gastric cancer patients and its clinical significance

AIM: To establish a more sensitive method for detection of free cancer cells in peritoneal washes from gastric cancer patients during surgery and to evaluate its clinical significance. METHODS: The carcinoembryonic antigen (CEA) mRNA levels in peritoneal washes from 65 cases of gastric cancer were detected by real-time RT-PCR. Peritoneal lavage cytology (PLC) was applied simultaneously to detection of free cancer cells. Negative controls included peritoneal washes from 5 cases of benign gastric disease and blood samples from 5 adult healthy volunteers. RESULTS: There was no CEA mRNA in peritoneal washes from benign gastric disease patients and in blood of adult healthy volunteers. The positive percentage of free cancer cells detected by real-time RT-PCR was 47.7% and only 12.3% by PLC. The positive rate of CEA mRNA was significantly related with serosa invasion between peritoneal metastasis and stage of gastric cancer. CONCLUSION: Real-time RT-PCR is a sensitive and rapid method for the detection of free cancer cells in peritoneal washes. The presence of free cancer cells in peritoneal washes is related to the pathologic stage of gastric cancer.     

Prognostic value of preoperative carcinoembryonic antigen/tumor size in rectal cancer

BACKGROUND Carcinoembryonic antigen(CEA)is a commonly used biomarker in colorectal cancer.However,controversy exists regarding the insufficient prognostic value of preoperative serum CEA alone in rectal cancer.Here,we combined preoperative serum CEA and the maximum tumor diameter to correct the CEA level,which may better reflect the malignancy of rectal cancer.AIM To assess the prognostic impact of preoperative CEA/tumor size in rectal cancer.METHODS We retrospectively reviewed 696 stage I to III rectal cancer patients who underwent curative tumor resection from 2007 to 2012.These patients were randomly divided into two cohorts for cross-validation:training cohort and validation cohort.The training cohort was used to generate an optimal cutoff point and the validation cohort was used to further validate the model.Maximally selected rank statistics were used to identify the optimum cutoff for CEA/tumor size.The Kaplan-Meier method and log-rank test were used to plot the survival curve and to compare the survival data.Univariate and multivariate Cox regression analyses were used to determine the prognostic value of CEA/tumor size.The primary and secondary outcomes were overall survival(OS)and disease-free survival(DFS),respectively.RESULTS In all,556 patients who satisfied both the inclusion and exclusion criteria were included and randomly divided into the training cohort(2/3 of 556,n=371)and the validation cohort(1/3 of 556,n=185).The cutoff was 2.429 ng/mL per cm.Comparison of the baseline data showed that high CEA/tumor size was correlated with older age,high TNM stage,the presence of perineural invasion,high CEA,and high carbohydrate antigen 19-9(CA 19-9).Kaplan-Meier curves showed a manifest reduction in 5-year OS(training cohort:56.7%vs 81.1%,P<0.001;validation cohort:58.8%vs 85.6%,P<0.001)and DFS(training cohort:52.5%vs 71.9%,P=0.02;validation cohort:50.3%vs 79.3%,P=0.002)in the high CEA/tumor size group compared with the low CEA/tumor size group.Univariate and multivariate analyses identified CEA/tumor size as an independent prognostic factor for OS(training cohort:hazard ratio(HR)=2.18,95%confidence interval(CI):1.28-3.73,P=0.004;validation cohort:HR=4.83,95%CI:2.21-10.52,P<0.001)as well as DFS(training cohort:HR=1.47,95%CI:0.93-2.33,P=0.096;validation cohort:HR=2.61,95%CI:1.38-4.95,P=0.003).CONCLUSION Preoperative CEA/tumor size is an independent prognostic factor for patients with stage I-III rectal cancer.Higher CEA/tumor size is associated with worse OS and DFS.     

动脉化疗对进展期胃癌CEA mRNA及CK19 mRNA表达的影响

目的:探讨外周血细胞CEAmRNA,CK19mRNA水平与胃癌EAP方案介入化疗近期疗效相关意义.方法:选择30例中晚期胃癌患者(Ⅱ期3例,Ⅲ期15例,Ⅳ期12例),于EAP(VP-16 ADM CBP)介入化疗前2-3d及化疗后2-3wk取外周血,全自动发光免疫法检测血清CEA及TPA,逆转录聚合酶链反应检测CEA及CK19mRNA.用超声内镜(EUS)结合CT测量肿块对化疗的有效率(CR PR)情况.结果:介入化疗前后外周血CEA及CK19mRNA均有显著差异[CEA:60.0%(18/30)vs33.3%(10/30),χ2=4.29,P<0.05;CK19:73.3%(22/30)vs46.7%(14/30),χ2=4.34,P<0.05].CEA及CK19mRNA联合检测阳性率在介入化疗前后也有显著差异[90.0%(27/30)vs50.0%(15/30),χ2=8.52,P<0.05].影像学诊断显示,外周血CEAmRNA,CK19mRNA联合检测阳性患者治疗前后分别为16例及5例(χ2=8.86,P<0.05).结论:外周血细胞CEAmRNA、CK19mRNA水平在EAP方案介入化疗后阳性率显著下降,CEAmRNA、CK19mRNA联合检测的敏感性高于血清CEA、TPA联合检测,可反应EAP方案介入化疗后肿瘤体积的变化情况.     

Cytokeratins and carcinoembryonic antigen in diagnosis, staging and prognosis of colorectal adenocarcinoma

AIM: To evaluate the serum levels of cytokeratins and carcinoembryonic antigen (CEA) in diagnosis, staging and prognosis of patients with colorectal adenocarcinoma.METHODS: The sample consisted of 169 patients. One hundred blood donors formed the control group. Radical surgery was performed on 120 patients, with an average follow-up duration of 22.3mo. Relapses occurred in 23individuals after an average of 18.09mo. CEA was assayed via the Delfia method with a limit of 5ng/mL. Cytokeratins were assayed via the LIA-mat TPA-M Prolifigen method with a limit of 72U/L. RESULTS: In the diagnosis of patients with colorectal adenocarcinoma, CEA showed a sensitivity of 56%, a specificity of 95%, a positive predictive value of 94%, a negative predictive value of 50% and an accuracy of 76.8%. TPA-M had a sensitivity of 70%, a specificity of 96%, a positive predictive value of 97%, a negative predictive value of 66% and an accuracy of 93.6%. The elevation of one of the markers was shown to have a sensitivity of 76.9%, a specificity of 91%, a positive predictive value of 93.5%, a negative predictive value of 70% and an accuracy of 83.6%. There was no variation in the levels of the markers according to the degree of cell differentiation while there was an elevation in their concentrations in accordance with the increase in neoplastic dissemination. There was a statistically significant difference between the patients with stage Ⅳ lesions and those with stages Ⅰ, Ⅱ and Ⅲ tumors.With regard to CEA, the average level was 14.2ng/mL in patients with stage Ⅰ lesions, 8.5ng/mL in patients with stage Ⅱ lesions, 8.0ng/mL in patients with stage Ⅲ lesions and 87.7ng/mL in patients with stage Ⅳ lesions. In relation to TPA-M, the levels were 153.1U/L in patients with stage Ⅰ tumors, 106.5U/L in patients with stage Ⅱ tumors, 136.3U/L in patients with stage Ⅲ tumors and 464.3U/L in patients with stage Ⅳ tumors. There was a statistical difference in patients with a high CEA level in relation to a shorter survival (P&lt;0.05). However, there was no correlation between patients with high TPA-M levels and prognostic indices of patients undergoing radical surgery.CONCLUSION: Cytokeratins demonstrate a greater sensitivity than CEA in the diagnosis of colorectal adenocarcinoma. There is an increase in the sensitivity of the markers with tumor dissemination.Cytokeratins cannot identify the worse prognosis in patients undergoing radical surgery.Cytokeratins constitute an advance in the direction of a perfect tumor marker in the treatment of patients with colorectal cancer.     

Cytokeratms and carcinoembryonic antigen in diagnosis, staging and prognosis of colorectal adenocarcinoma

AIM: To evaluate the serum levels of cytokeratins and carcinoembryonic antigen (CEA) in diagnosis, staging and prognosis of patients with colorectal adenocarcinoma. METHODS: The sample consisted of 169 patients. One hundred blood donors formed the control group. Radical surgery was performed on 120 patients, with an average follow-up duration of 22.3 mo. Relapses occurred in 23 individuals after an average of 18.09 mo. CEA was assayed via the Delfia method with a limit of 5 ng/mL Cytokeratins were assayed via the LIA-mat TPA-M Prolifigen method with a limit of 72 U/L. RESULTS: In the diagnosis of patients with colorectal adenocarcinoma, CEA showed a sensitivity of 56%, a specificity of 95%, a positive predictive value of 94%, a negative predictive value of 50% and an accuracy of 76.8%. TPA-M had a sensitivity of 70%, a specificity of 96%, a positive predictive value of 97%, a negative predictive value of 66% and an accuracy of 93.6%. The elevation of one of the markers was shown to have a sensitivity of 76.9%, a specificity of 91%, a positive predictive value of 93.5%, a negative predictive value of 70% and an accuracy of 83.6%. There was no variation in the levels of the markers according to the degree of cell differentiation while there was an elevation in their concentrations in accordance with the increase in neoplastic dissemination. There was a statistically significant difference between the patients with stage IV lesions and those with stages I, II and III tumors. With regard to CEA, the average level was 14.2 ng/mL in patients with stage I lesions, 8.5 ng/mL in patients with stage II lesions, 8.0 ng/mL in patients with stage III lesions and 87.7 ng/mL in patients with stage IV lesions. In relation to TPA-M, the levels were 153.1 U/L in patients with stage I tumors, 106.5 U/L in patients with stage II tumors, 136.3 U/L in patients with stage III tumors and 464.3 U/L in patients with stage IV tumors. There was a statistical difference in patients with a high CEA level in relation to a shorter survival (P<0.05). However, there was no correlation between patients with high TPA-M levels and prognostic indices of patients undergoing radical surgery. CONCLUSION: Cytokeratins demonstrate a greater sensitivity than CEA in the diagnosis of colorectal adenocarcinoma. There is an increase in the sensitivity of the markers with tumor dissemination. Cytokeratins cannot identify the worse prognosis in patients undergoing radical surgery, Cytokeratins constitute an advance in the direction of a perfect tumor marker in the treatment of patients with colorectal cancer.     

探讨老年胃癌患者胃液中TNF-α,CA19-9和CEA联合检测的临床价值

目的:探讨老年患者胃液中TNF-α,CA19-9和CEA联合检测对胃癌的诊断价值．方法:采用放射免疫技术测定42例胃癌和61例良性胃病老年患者胃液中TNF-α,CA19-9和CEA浓度．结果:胃癌组胃液中TNF-α,CA19-9和CEA的浓度显著高于良性胃病组(8．96±2．10 mg／L vs 4．92±1．24．5．66±1．25 mg／L;59．47±10．58 IU／L vs 36．89±11．23．38．73±9．23 IU／L; 31．68±5．58 mg／L vs 1'．55±3．82,19.42±5．19 mg／L,均P<0．001);胃癌组联合检测胃液中TNF-α,CA19-9和CEA,其敏感度和特异度分别97．4％,89．3％,均明显高于单项指标的敏感度和特异度．结论:联合检测胃液中TNF-α,CA19-9和CEA能有助于提高胃癌的诊断．     

胆囊癌患者血清sVEGF-C和CEA水平变化及其与组织病理学特征的关系探讨*

目的 研究血清血管内皮生长因子-C(sVEGF-C)和癌胚抗原(CEA)水平与胆囊癌患者临床和病理学特征的关系。方法 2011年2月～2018年1月收治的93例胆囊癌患者,采用双抗体夹心酶联免疫吸附法检测血清sVEGF-C水平,采用放射免疫分析法检测血清CEA水平,分析血清sVEGF-C和CEA水平与胆囊癌患者临床和病理学特征的关系。结果 不同肿瘤浸润程度(T分期)、肿瘤淋巴转移程度(N分期)、肿瘤远处转移(M分期)的胆囊癌患者血清sVEGF-C和CEA水平相差显著(P＜0.05);中位随访22个月,在93例患者中死亡48例(51.6%),生存45例(48.4%);死亡组血清sVEGF-C水平为(84.9±20.7)pg/mL,显著高于生存组[(56.4±18.9)pg/mL,P＜0.05],血清CEA水平为(138.7±49.6)μg/L,显著高于生存组[(76.8±27.4)μg/L,P＜0.05];多因素Logistic回归分析显示,临床病理分期(OR=6.658,95%CI=1.800～24.632)及血清sVEGF-C(OR=4.005,95%CI=1.292～12.415)和CEA(OR=3.170,95%CI=1.482～6.849)水平是影响胆囊癌患者预后的独立危险因素(P＜0.05)。结论 胆囊癌患者血清sVEGF-C和CEA水平显著升高,可能与不良预后相关,值得积极的深入研究。     

进展期大肠癌患者术中应用化疗药物外周血CEA、CA19-9的检测及临床意义

目的:检测大肠癌患者术中应用化疗药物后,手术前后血清CEA和CAl9-9的变化,确定其对预防大肠癌微转移,降低术后复发率和死亡率的临床意义.方法:采用ELISA方法测定30例术中应用化疗药物大肠癌患者及30例术中未应用化疗药物大肠癌患者手术前后外周血中CEA和CAl9-9含量的变化,同时选用30例非肿瘤人群作为正常对照.结果:60例大肠癌患者(Duck C期)术前外周血中CEA,CAl9-9均值高于正常值(60.73±25.99 mg/L vs 2.67±1.643 mg/L,P＜0.01;112.73±78.76 kU/L vs 14.6±6.68 kU/L,P＜0.01).30例术中应用化疗药物的大肠癌患者手术后血清CEA、CAl9-9下降较快(术后7 d:7.96±3.32 mR/L,29.34±11.05 kU/L,P＜0.01 vs术前),术中未应用化疗药物组的大肠癌患者术后血清CEA和CA-199下降缓慢(术后7 d:34.23±20.59 mg/L,88.12±32.28 kU/L,P＞0.05 vs 术前).结论:通过定量检测大肠癌患者外周血CEA和CAl9-9的含量,证明手术中温热灌注化疗 动脉化疗以及术后联合化疗的辅助治疗是十分必要的,对预防大肠癌微转移,降低术后复发率和死亡率的有重要的临床意义.     

Towards personalized perioperative treatment for advanced gastric cancer

Gastric cancer is one of the most frequently diagnosed cancers worldwide. Although the rate of gastric cancer has declined dramatically over the past decades in most developed Western countries, it has not declined in East Asia. Currently, a radical gastrectomy is still the only curative treatment for gastric cancer. Over the last twenty years, however, surgery alone has been replaced by a multimodal perioperative approach. To achieve the maximum benefit from the perioperative treatment, a thorough evaluation of the tumor must first be performed. A complete assessment of gastric cancer is divided into two parts: staging and histology. According to the stage and histology of the cancer, perioperative chemotherapy or radiochemotherapy can be implemented, and perioperative targeted therapies such as trastuzumab may also play a role in this field. However, perioperative treatment approaches have not been widely accepted until a series of clinical trials were performed to evaluate the value of perioperative treatment. Although multimodal perioperative treatment has been widely applied in clinical practice, personalization of perioperative treatment represents the next stage in the treatment of gastric cancer. Genomic-guided treatment and efficacy prediction using molecular biomarkers in perioperative treatment are of great importance in the evolution of treatment and may become an ideal treatment method.     

Immunoperoxidase staining of carcinoembryonic antigen as a prognostic indicator in colorectal carcinoma

Immunoperoxidase staining for carcinoembryonic antigen (CEA) was performed on 192 colorectal carcinomas to determine: whether tissue staining can be substituted for preoperative serum CEA levels, and whether patient survival can be predicted by these parameters. The overall incidence of positive tissue staining was 75 percent, which was similar to the elevated serum level percentage of 73 percent. Both the serum CEA level and the CEA tissue stain correlated with patient survival in Dukes' stage C patients. There was no correlation between tissue CEA stain and tumor differentiation. Positive tissue stain and elevated preoperative serum CEA identified patients with poor prognosis in Dukes' stage D only. This study shows that tissue staining with immunoperoxidase may be substituted for preoperative serum levels for CEA. The combination of these two parameters, however, does not identify patients at greater risk for recurrence than either procedure alone. Supported by a grant from the Veterans Administration.     

Oxaliplatin in perioperative chemotherapy for gastric and gastroesophageal junction (GEJ) adenocarcinoma

Introduction: Platinum-based chemotherapy remains standard-of-care for gastric and gastroesophageal junction (GEJ) adenocarcinoma. For locally advanced resectable disease, perioperative treatment with cisplatin-based doublet or triplet chemotherapy regimens had been the predominant approach in Europe and the US, based on pivotal phase III trials including the MAGIC study. Results from more recent landmark studies including the German FLOT4 and the Asian CLASSIC trials have, however, triggered a shift from cisplatin towards oxaliplatin-based chemotherapy protocols in the perioperative setting.

Areas covered: This drug profile summarizes current state-of-the-art of perioperative and adjuvant treatment for locally advanced resectable gastric/GEJ cancers with a special focus on the increasingly predominant role of oxaliplatin over cisplatin in this setting. We review pharmacology, clinical efficacy, and safety profile of oxaliplatin and oxaliplatin combination regimens. We highlight recent advances and ongoing developments in the field.

Expert opinion: While the adoption of oxaliplatin-containing combination regimens for perioperative therapy of gastric/GEJ cancers represents a significant step ahead, many pivotal questions remain unanswered. At the sample time, the evolution of molecular subtyping and immunotherapy is likely to dramatically change clinical practice in the foreseeable future.     

甲胎蛋白与癌胚抗原联合检测在肝癌鉴别诊断中应用价值

目的探讨联合检测甲胎蛋白(AFP)与癌胚抗原(CEA)在原发性肝癌和转移性肝癌诊断中的应用价值。方法选择经临床病理学检查确诊的肝癌患者98例,根据疾病诊断分为原发性肝癌组(56例)和转移性肝癌组(42例),同期健康体检者作为对照组(30例)。采用电化学发光法测定血清AFP和CEA浓度,并对3组结果进行分析。结果原发性肝癌组血清AFP和CEA含量均明显高于对照组(P均0.05),原发性肝癌组血清AFP含量明显高于转移性肝癌组,差异有统计学意义(P=0.012);转移性肝癌组中CEA含量均明显高于原发性肝癌组和健康对照组,差异有显著统计学意义(P均0.01)。结论联合检测血清AFP和CEA的含量能更好地诊断和鉴别诊断原发性肝癌与转移性肝癌,对鉴别肝癌的类型具有一定的指导意义。     

癌胚抗原在不同驱动基因肺癌患者中的差异性

目的 通过回顾性分析不同驱动基因肺癌患者的血清癌胚抗原(CEA)水平,探讨CEA在不同驱动基因肺癌患者中的差异性.方法 选择2015年9月至2018年12月唐都医院呼吸与危重症医学科经治的210例肺癌患者,分别采用电化学发光免疫分析法和探针扩增阻滞突变系统聚合酶链反应法检测CEA水平及基因突变状况,分析不同驱动基因肺癌...     

Comparative analysis of cancer-associated antigen CA-195, CA19-9 and carcinoembryonic antigen in diagnosis,follow-up and monitoring of response to chemotherapy in patients with gastrointestinal cancer

Summary To establish further the clinical significance of the CA-195 tandem immunoradiometric assay in gastrointestinal malignancies, the sera of a total of 222 subjects have been analysed and compared with assays of the classical gastrointestinal tumour markers, CA19-9 and carcinoembryonic antigen (CEA). CA-195 elevations above normal (>10 U/ml) were noted in 51/72 (70.8%) colorectal, 15/15 (100%) pancreatic, and in 6/12 (50%) gastric cancer patients. Whereas CA19-9 was increased (>37 U/ml) in 65%, 93%, and 42% of cases, only 54% colorectal, 45% pancreatic, and 42% gastric cancer patients had pathologically elevated serum CEA levels (>5 ng/ml). No abnormal increase of both CA-195 and CA19-9 was found in healthy volunteers, whereas 3/20 (smoking) individuals had CEA levels slightly above normal. With a 29% false-positive rate noted among 103 patients with benign gastroinestinal disorders, the specifity of CA-195 was superior to that of CA19-9 (58%) and comparable with that of CEA (31%). A significant correlation between CA-195 levels and the clinical/pathological stage of disease was noted in colorectal (P<0.01) and pancreatic cancer patients (P<0.007). Preliminary results of serial measurements of CA-195 in colorectal cancer suggest that this new marker protein, which has no cross-reactivity with CEA, may be useful as a non-invasive test for postoperative surveillance of patients to detect disease recurrence, and serve to complement (though certainly not replace) standard clinical measurements of response to chemotherapy.Abbreviation CEA carcinoembryonic antigen     

The role of serum and gastric juice levels of carcinoembryonic antigen, CA19.9 and CA72.4 in patients with gastric cancer

Purpose: The aim of the present study was to investigate carcinoembryonic antigen (CEA), CA19.9, and CA72.4 in the serum and gastric juice of patients with gastric cancer. Methods: Serum and gastric juice tumor markers CEA, CA19.9, and CA72.4 were measured in 59 patients who had gastric adenocarcinomas and were undergoing curative gastrectomy. The same markers were measured in 47 patients with benign gastric disorders and in 40 healthy subjects. The correlation between the serum and gastric juice levels of tumor markers and several clinicopathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factors was assessed both by univariate and multivariate analysis. Results: The positivity rates of serum CEA, CA19.9, and CA72.4 were 57.6%, 38.9%, and 18.6% respectively. The positivity rates of gastric juice CEA, CA19.9, and CA72.4 were 62.7%, 30.5%, and 23.7% respectively. The combination of serum and gastric juice markers gave a positivity of 81.3%. There was no correlation between serum and gastric juice level of each tumor marker. Positivity of gastric juice markers did not correlate with prognosis. A significant difference in prognosis was observed between patients positive and negative for serum CEA and CA19.9. Multivariate analysis also revealed that serum CEA and CA19.9 levels were independent prognostic factors. Conclusions: Levels of both serum and gastric juice tumor markers continue to have only limited diagnostic usefulness in gastric cancer patients. CEA and CA19.9 in the preoperative sera are good prognostic factors, whereas the presence of tumor markers in the gastric juice does not play any prognostic role. Received: 19 January 1998 / Accepted: 14 April 1998     

Neoadjuvant chemotherapy for advanced gastric cancer: a meta-analysis

AIM:To study the value of neoadjuvant chemotherapy (NAC) for advanced gastric cancer by performing a meta-analysis of the published studies.METHODS:All published controlled trials of NAC for advanced gastric cancer vs no therapy before surgery were searched.Studies that included patients with metastases at enrollment were excluded.Databases included Cochrane Library of Clinical Comparative Trials,MEDLINE,Embase,and American Society of Clinical Oncology meeting abstracts from 1978 to 2010.The censor date was...     

外周血液CEAmRNA基因表达与食管癌微转移关系的研究

目的探讨靶基因CEAmRNA在食管癌患者外周血中的表达及与肿瘤微转移的关系.方法应用巢式-反转录聚合酶链反应(Nested-RT-PCR)检测50例无远处转移、10例有远处转移的食管癌患者,10例食管良性病变和10例健康成人外周血中癌胚抗原CEAmRNA基因的表达.结果食管癌良性病变者和健康成人的外周血中均未检测出CEAmRNA阳性细胞.50例无远处转移、10例有远处转移的食管癌患者外周血中CEAmRNA阳性率分别为30.2%(16/50)、80.0%(8/10),P＜0.01;食管癌Ⅳ期与Ⅱa、Ⅱb、Ⅲ期者阳性率比较差异有显著性(P均＜0.01),而其他各期之间阳性率比较差异无显著性(P＞0.05);不同程度病理分化者间阳性率比较差异无显著性(P＞0.05).结论食管癌患者临床早期已有癌细胞微转移.应用Nested-RT-PCR检测外周血中CEAmRNA靶基因有助于早期诊断.     

Neoadjuvant plus adjuvant chemotherapy benefits overall survival of locally advanced gastric cancer

Neoadjuvant chemotherapy (NAC) has drawn more attention to the treatment of locally advanced gastric cancer (AGC) in the current multidisciplinary treatment model. EORTC trial 40954 has recently reported that NAC plus surgery without postoperative adjuvant chemotherapy could not benefit the locally AGC patients in their overall survival. We performed a meta-analysis of 10 studies including 1518 gastric cancer patients. Stratified subgroups were NAC plus surgery and NAC plus both surgery and adjuvant chemoth...