贝伐单抗与卡培他滨联合奥沙利铂对术后老年晚期胃癌血清CA199、CEA、CA242及生活质量的影响

目的 探讨老年晚期胃癌患者术后采用贝伐单抗与卡培他滨联合奥沙利铂方案治疗临床疗效,并观察其对患者血清肿瘤标志物及生活质量的影响.方法 60例经手术组织病理证实为晚期胃癌患者,均行腹腔镜胃癌根治术治疗,术后对照组(30例)予以多西他赛注射液+顺铂+氟尿嘧啶;治疗组(30例)给予奥沙利铂注射液+贝伐单抗+卡培他滨片.检测两组患者治疗前、后血清肿瘤标志物变化,记录两组患者疾病进展时间及平均生存时间;采用采用医院自制问卷调查表对患者生活质量进行调查.统计两组患者临床疗效及不良反应.结果 治疗组治疗后CA199、CA242及CEA水平分别为(194.2±45.8)mg/L、(32.9±8.1)mg/L、(18.1±6.2)mg/L,明显低于对照组(279.6±46.9)mg/L、(58.7±8.8)mg/L、(29.7±7.4)mg/L,t=(7.13,11.81,6.58),P=(0.00,0.00,0.00);两组各项血清肿瘤标志物水平均明显低于治疗前,P<0.05.治疗组疾病进展时间、平均生存时间分别为(6.2±3.1)个月、(11.8±4.2)个月,明显长于对照组[(4.1±2.0)个月、(7.9±1.9)个月],t=(3.11,4.63),P=(0.00,0.00).经干预后,治疗组患者躯体症状、睡眠质量、精神状态、社会情感积分明显明显高于对照组,P<0.05;治疗组治疗总有效率(76.7％),明显高于对照组(43.3％),x2=6.94,P=0.00;治疗组不良反应率(20.0％)明显低于对照组(53.3％),x2=7.17,P=0.00.结论 老年晚期胃癌患者术后采用贝伐单抗与卡培他滨联合奥沙利铂方案治疗疗效显著且不良反应少,有利于改善患者生活质量及延长其生存期.     

血清CEA、CA199和CA153检测对判定结肠癌发生发展的价值分析

目的 探讨结肠癌患者的血清CEA、CA199和CA153检测对判定病情的价值.方法 选择结肠癌患者60例(癌变组)、良性结肠肿瘤患者60例(瘤变组)与健康人60例(健康组),收集各组患者空腹静脉血后进行血清CEA、CA199和CA153的检测,同时对3组入选者的一般资料与临床特点进行记录与分析.结果 癌变组的CEA、CA199和CA153含量都明显高于瘤变组与健康组,3组间的对比差异都有统计学意义(P<0.05).癌变组的CEA、CA199和CA153表达阳性率分别为55.0%、70.0%和63.3%,瘤变组分别为6.7%、6.7%和1.7%,而健康组分别为3.3%、3.3%和0.0%,3组间的对比差异有统计学意义(P<0.05).在结肠癌患者中,随着病理分期增加、分化程度的减少和淋巴结转移的发生,CEA、CA199和CA153的表达阳性率明显增加(P<0.05).结论 血清CEA、CA199和CA153在结肠癌中都呈现高表达情况,与患者的病理特征与病情有一定的相关性,能有效判定病情状况,值得在临床检测中推广应用.     

异常凝血酶原联合CEA、CA72-4和CA199在胃癌诊治中的价值

目的 拟评估异常凝血酶原（PIVKA-Ⅱ）联合CEA、CA199和CA72-4在胃癌的诊断、治疗及复发转移监测中的应用价值。方法 化学发光法检测123例胃癌患者、80名健康对照者以及30例胃良性疾病患者血清中的PIVKA-Ⅱ水平及CEA、CA199、CA72-4水平,并对其中20例胃癌患者进行随访检测。结果 胃癌患者血清PIVKA-Ⅱ水平明显高于胃部良性疾病患者和健康对照者（均P<0.001）。ROC曲线分析,PIVKA-Ⅱ检测胃癌的临界值为32.14 U/L、敏感度为39.84%、特异性为95%,相比于CEA、CA199、CA72-4的检测,敏感度未有显著提高,特异性稍低。胃癌患者血清PIVKA-Ⅱ水平及阳性率随着肿瘤分期的升高而升高（均P<0.05）。进行有效治疗的20例进展期胃癌患者PIVKA-Ⅱ水平下降。四项组合诊断胃癌的敏感度和有效性最高。结论 PIVKA-Ⅱ联合CEA、CA199、CA72-4检测在胃癌的诊断、疗效及监测复发转移中,具有一定的临床价值。     

胃癌患者化疗前后血清VEGF、CA199水平的变化及临床价值

目的探讨胃癌患者化疗前后血清VEGF、CA199水平的变化及临床价值。方法选取胃癌患者40例,作为胃癌组,另选取同期接收40例健康体检人员为健康组,胃癌组患者给予化疗,化疗前后分别采用ELISA法对两组人员的血清VEGF、CA199水平进行测定,然后对胃癌组患者的化疗效果进行评定。结果胃癌组血清VEGF、CA199水平均显著高于健康组(P<0.05),40例患者中,CR 12例,PR 13例,NC 10例,PD 5例,总缓解率为62.5%(25/40),所有患者化疗后的血清VEGF、CA199水平均显著低于化疗前(P<0.05);化疗前后CR+PR、NC患者血清VEGF、CA199水平均显著低于PD患者(P<0.05),而化疗后CR+PR患者的血清VEGF、CA199水平又均显著低于NC患者(P<0.05)。结论胃癌患者化疗前后血清VEGF、CA199水平的变化能够将有效依据提供给治疗效果的评定。     

香菇多糖辅助胃癌患者术后化疗的临床观察

目的 :探讨香菇多糖减轻胃癌患者术后化疗毒副反应的效果和对患者长期生存的影响。方法 :设计两组患者作为研究对象 ,对照组 (n =5 1)用 5 Fu、阿霉素、丝裂霉素方案 ;治疗组 (n =32 )用香菇多糖、5 Fu、阿霉素、丝裂霉素方案。毒副反应按WHO标准评估 ,长期生存及长期无瘤生存用寿命表法分析。结果 :治疗组比对照组在血液学 (P <0 0 1)、胃肠道 (P <0 0 1)、皮肤及毛发 (0 0 5 >P >0 0 1)上的毒副反应明显下降 ;且较对照组能耐受更多疗程化疗 (P <0 0 1) ;但在五年生存率及五年无瘤生存率上治疗组与对照组无显著性差异 (五年生存率分别是 4 6 88%和 4 5 10 % ,P >0 0 5 ,五年无瘤生存率相同 )。结论 :香菇多糖可减少胃癌患者术后化疗的毒副反应 ,但对长期生存无明显影响     

FOLFOX 4→DCF方案一线治疗晚期胃癌的临床观察

目的探讨FOLFOX4→DCF方案治疗晚期胃癌的疗效和安全性。方法25例晚期胃癌患者先采用FOLFOX4方案化疗,14天为1个周期,治疗3个周期。FOLFOX4方案化疗3个周期结束后第14天开始给予DCF方案化疗,21天为1个周期,治疗3个周期。结果第15周复查显示：完全缓解（CR）4例（16%）,部分缓解（PR）11例（44%）,稳定（SD）6例（24%）,进展（PD）4例（16%）,总有效率（CR＋PR）为60%（15/25）,疾病控制率84%（21/25）。中位疾病进展时间（TTP）为7.8个月（95%可信区间,3.8～12.2个月）,中位生存期（MST）为11.7个月（95%可信区间,5.8～16.7个月）,1年生存率为44%（11/25）。毒性反应主要是中性粒细胞减少。结论FOLFOX4→DCF方案治疗晚期胃癌具有较好的疗效和安全性。     

奥沙利铂联合卡培他滨一线治疗晚期转移性胃癌的临床疗效观察

目的探讨奥沙利铂联合卡培他滨作为一线方案治疗晚期转移性胃癌的疗效和安全性。方法27例既往未接受过化疗的晚期转移性胃癌患者采用奥沙利铂联合卡培他滨（XELOX方案）化疗：奥沙利铂130 mg/m²,静脉滴注2小时,d1;卡培他滨2 000 mg/m²,分2次口服,d1～14,21天为一周期。患者最多接受8个周期化疗。结果27例患者共接受124个周期化疗,中位化疗周期数为5个。所有患者均可评价疗效,其中部分缓解12例(44.5%),稳定8例(29.6%), 进展7例(25.9%);客观有效率44.5%(95%可信区间:25.8%～63.2%)。平均随访9.2月,中位疾病进展时间5.0月（95%可信区间：2.6～7.4月）,中位生存时间9.7月（95%可信区间：6.5～12.9月）。常见不良反应有骨髓抑制、外周神经毒性、胃肠道反应、手足综合征等,无治疗相关性死亡。结论XELOX方案一线治疗晚期转移性胃癌疗效显著,耐受性良好。     

Clinical Response to Systemic Combined Chemotherapy with 5-Fluorouracil and Cisplatin (FP Therapy) in Patients with Advanced Pancreatic Cancer

Pancreatic cancer shows high mortality and has a poor prognosis.Although the rate of response to all chemotherapeutic regimensis low, some patients have shown improvement of their symptomsafter chemotherapy and/or radiotherapy without obvious tumorregression. We assessed the clinical benefit of systemic combinedchemotherapy with 5-fluorouracil and cisplatin (FP therapy)in 21 patients with advanced cancer of the pancreas. The clinicalresponse to FP therapy was evaluated using two parameters: pain(intensity of pain and consumption of morphine) and performancestatus. A patient was considered to be a clinical responderif one of two parameters was positive and the other was positiveor stable. Four patients (19%) responded. Two of the respondersachieved partial response according to the objective tumor response,and the remaining two showed no change. The survival periodin responders was significant longer than in the other patients.The clinical response may be one parameter for evaluating theresults of treatment for pancreatic cancer, and the longer survivalperiod of the clinical responders in this study supports thisnotion.     

含多西他赛方案一线治疗进展期胃癌的临床观察

目的 探讨含多西他赛的四种不同一线化疗药物对进展期胃癌的治疗效果.方法 选择苏州大学附属第一人民医院肿瘤科2012年7月至2014年6月收治的246例胃癌患者(进展期)为研究对象,根据化疗方案不同分为4组:多西他赛+ DDP+ 5-fu(A组,n=32)、多西他赛+奥沙利铂+卡培他滨(B组,n=80)、多西他赛+奥沙利铂(C组,n=118)和多西他赛+卡培他滨(D组,n=16).分析4组的有效率(RR)、疾病控制率(DCR)、无进展生存期(PFS))及治疗期间的不良反应等.结果 A、B、C和D组的RR分别为46.9％、48.8％、45.8％和37.5％,A组、B组、C组的RR均高于D组,差异有统计学意义(P ＜0.05);DCR分别为87.5％、91.3％、87.3％和87.5％,4组比较差异无统计学意义(P＞0.05).4组中位PFS分别为7.8、8.2、8.0和7.5个月.在4组患者中,3～4级不良反应:白细胞减低发生率均超过15.0％,而其余不良反应发生率均低于10.0％;A、B组恶心呕吐、乏力及白细胞减少等不良反应发生率均高于其他两组(P＜0.05).结论 根据患者不同状况,以多西他赛为基础的多药联合,可作为进展期胃癌的一线治疗方案.     

Neutrophil Count and the Inflammation-based Glasgow Prognostic Score Predict Survival in Patients with Advanced Gastric Cancer Receiving First-line Chemotherapy

Purpose: To explore the value of systemic inflammatory markers as independent prognostic factors andthe extent these markers improve prognostic classification for patients with inoperable advanced or metastaticgastric cancer (GC) receiving palliative chemotherapy. Methods: We studied the prognostic value of systemicinflammatory factors such as circulating white blood cell count and its components as well as that combined toform inflammation-based prognostic scores (Glasgow Prognostic Score (GPS), Neutrophil-Lymphocyte Ratio(NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI) and Prognostic Nutritional Index (PNI)) in 384patients with inoperable advanced or metastatic gastric cancer (GC) receiving first-line chemotherapy. Univariateand multivariate analyses were performed to examine the impact of inflammatory markers on overall survival(OS). Results: Univariate analysis revealed that an elevated white blood cell, neutrophil and/or platelet count,a decreased lymphocyte count, a low serum albumin concentration, and high CRP concentration, as well aselevated NLR/PLR , GPS, PI, PNI were significant predictors of shorter OS. Multivariate analysis demonstratedthat only elevated neutrophil count (HR 3.696, p=0.003) and higher GPS (HR 1.621, p=0.01) were independentpredictors of poor OS. Conclusion: This study demonstrated elevated pretreatment neutrophil count and highGPS to be independent predictors of shorter OS in inoperable advanced or metastatic GC patients treated withfirst-line chemotherapy. Upon validation of these data in independent studies, stratification of patients usingthese markers in future clinical trials is recommended.     

晚期胃癌非根治性术后腹腔联合静脉化疗与单纯静脉化疗的临床观察

目的: 探讨晚期胃癌非根治性术后腹腔热灌注化疗联合FOLFOX4方案静脉化疗的临床疗效及毒副反应。 方法: 选取青岛市肿瘤医院2002年1月至2005年2月65例晚期胃癌姑息性切除术后患者随机分为两组,治疗组采用术后腹腔热灌注化疗顺铂(DDP)60～80mg/m²、丝裂霉素(MMC)4～6mg/m²、5-氟脲嘧啶(5-FU)75mg/m²,2周为1个周期并联合FOLFOX4(L-OHP85mg/m²静脉滴注2h,d₁;LV200mg/m²静脉滴注2h,d₁～2;5-FU400mg/m²,LV滴完10～20min静脉推注d_1～2;5-FU600mg/m²推注后22h,civ,d_1～2,2周为1个周期)方案静脉化疗,对照组术后采用单一DF(5-FU500mg/m²d_1～3、LV200mg/m²d_1～3、DDP30～40mg/m²d_1～3,或将5-FU2.4mg/m²经携式微量输注泵在48h内连续注入,每3～4周为1个周期)方案静脉化疗,对65例患者的临床资料作回顾性分析。 结果: 治疗组1、2、3年生存率分别为83.3%(28/34)、58.8%(20/34)、44.2%(14/34),对照组为83.9%(26/31)、29.0%(9/31)、16.1%(5/31),两组1年生存率比较无显著性差异(P>0.05),2、3年生存率比较有显著性差异(P<0.05);两组化疗毒副反应比较除外周神经损害外无显著性差异。治疗组腹腔化疗并发症主要为腹痛、腹胀、腹泻、便秘。 结论: 晚期胃癌姑息性切除术后腹腔热灌注化疗联合FOLFOX4静脉化疗在晚期胃癌的综合治疗中是一种有效的治疗措施。     

胃癌患者术后化疗时机的选择

为了研究胃癌患者术后免疫功能的变化并选择合适的时机进行化疗，作者对４８例胃癌患者术后不同时期和化疗前后外周血ＮＫ细胞活性和Ｔ细胞亚群进行了检测。结果显示，肿瘤切除后第二周和第三周患者免疫功能均有明显改善，但二者无明显差别（Ｐ＞０．０５）。说明术后免疫功能恢复到一定程度后稳定在一定水平。因此从免疫状态看，术后一周左右化疗是合适的。另外化疗前后免疫指标变化揭示，化疗对患者免疫功能确有损害作用。     

血清肿瘤标志物与一线EGFR-TKIs治疗晚期EGFR突变型肺腺癌患者疗效相关性分析

背景与目的 表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinaseinhibitors,EGFR-TKIs)在EGFR突变型肺腺癌人群中能显著提高生存,从而改变了晚期肺癌的治疗模式,但并不是所有EGFR敏感突变者均能从EGFR-TKIs治疗中获益.本研究欲通过外周血肿瘤标志物的检测对突变型肺腺癌患者的靶向治疗进行预测及指导.方法 回顾性分析2009年6月-2014年6月于北京大学肿瘤医院胸部肿瘤内一科一线接受EGFR-TKIs治疗的EGFR突变型Ⅲb期-Ⅳ期肺腺癌患者的临床资料,分析其基线肿瘤标志物与EGFR-TKIs疗效及生存的关系.结果 总体人群客观有效率(objective response rate,ORR) 52.8％,疾病控制率(disease control rate,DCR) 89.3％.基线癌胚抗原(carcino-embryonic antigen,CEA)水平升高者对EGFR-TKIs疗效更佳(ORR 61.3％vs35.9％,DCR 95.2％vs 74.4％,P＜0.001),治疗1个月后CEA、细胞角蛋白19片段(cytokeratin 19 fragments,CYFRA21-1)以及CA125水平下降者有效率更高(ORR分别是61.5％vs 25％,P=0.002;58.5％vs 37.5％,P=0.004;61.8％vs 20％,P=0.027).生存分析中,基线CEA水平正常者较高水平者无进展生存期(progression-free survival,PFS)明显缩短(中位PFS5.9个月vs9.8个月,P=0.027),而基线CYFRA21-1、CA125水平升高者PFS明显缩短(中位PFS 9.0个月vs11.4个月,P=0.029;9.0个月vs 11.5个月,P=0.023).多因素分析显示,美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)评分0-1分、基线CYFRA21-1正常水平、治疗1月后CEA下降阳性患者PFS更长.总生存期(overall survival,OS)与CYFRA21-1、CA125升高有关(中位OS分别为25.1个月vs 52.5个月,P=0.003;22.7个月vs55.0个月,P＜0.001),而多因素分析中总生存与CEA下降有关(P=0.046).结论 治疗前高水平CEA以及治疗后CEA下降可以预测晚期肺腺癌患者一线接受EGFR-TKIs的疗效,而治疗前高水平CYFRA21-1以及CA125则预示着生存期缩短.     

晚期NSCLC患者血清CEA、NSE、CYFRA211、CA125、CA199检测的临床及预后意义

目的 探讨晚期非小细胞肺癌（NSCLC）患者血清CEA、NSE、CYFRA211、CA125及CA199水平在临床及预后中的意义。方法 化疗前、后检测95例初治晚期NSCLC患者血清CEA、NSE、CYFRA211、CA125及CA199水平。结果 95例患者疗前血清CEA、NSE、CYFRA211、CA125及CA199的阳性率分别为53．7％、70．5％、62．2％、54．1％及31．6％。化疗后部分缓解者的肿瘤标志物水平均明显下降（P值分别为0．030、0．000、0．009、0．002和0．034）。本组患者1年生存率为52．7％（50／95）,2年生存率为14．7％（14／95）,中位生存14个月（部分缓解者17月,稳定者13月,进展者6月）。COX模型多因素分析表明,患者预后与首程化疗疗效、分期、疗前行为状态、CYFRA211有密切关系,与病理分型、疗前CEA、NSE、CA125及CA199无明显关系。结论 CEA、NSE、CYFRA211、CA125及CA199值下降可评价化疗疗效,NSCLC患者的TNM分期、疗前行为状态、疗前CYFRA211及首程化疗疗效有预后意义。     

多西他赛联合卡培他滨治疗老年晚期胃癌的疗效分析

目的评价多西他赛联合卡培他滨方案治疗老年晚期胃癌的疗效和毒性反应。方法30例老年晚期胃癌患者接受多西他赛75mg／m2静脉滴注,第1天;卡培他滨2000mg／m2,分两次口服,第1～14天;3周为1个周期。治疗至少2个周期后评价疗效及不良反应。结果可评价疗效者30例,治疗后获得完全缓解（CR）1例,部分缓解（PR）12例。稳定（SD）10例,进展（PD）7例,总有效率（R．R）为43．3％（13／30）。中位疾病进展时间（TTP）为5．2个月,中位生存期（MST）为9．0个月。临床获益率为73．3％。主要不良反应为骨髓抑制、脱发、腹泻、手足综合征。结论多西他赛联合卡培他滨治疗老年晚期胃癌具有较好的疗效,且不良反应可耐受。     

肿瘤标志物对胃癌诊断及预后的评估价值

目的探讨肿瘤标志物水平变化对胃癌诊断及预后评估的价值。方法经手术与病理学确诊的198例胃癌患者作为病例组,同时选择198例于我院体检均为健康者为对照组。采用电化学发光法检测2组患者血清中肿瘤标志物CEA、CA724、CA199的水平,并评价3种肿瘤标志物的灵敏度、特异度。结果病例组3种肿瘤标志物的含量均高于对照组,且差异均有统计学意义。同时术后该3种肿瘤标志物的水平均低于术前,差异均有统计学意义。同时（Ⅲ＋Ⅳ）期患者肿瘤标志物水平明显高于（Ⅰ＋Ⅱ）期,差异均有统计学意义。病例组患者CEA、CA724、CA199的灵敏度分别为50．9％,51．3％,47．8％;特异度分别为92．1％,91．4％,89．5％;三者联合检测的灵敏度和特异度分别达90．1％,73．4％。结论血清CEA、CA724、CA199对于胃癌的诊断有一定的辅助诊断价值,同时三者联合检测可以提高其诊断的敏感度,对于预后胃癌患者的预后有较高的评估价值。     

奥沙利铂联合替加氟持续静脉注射治疗晚期胃癌临床观察

 目的 观察奥沙利铂与替加氟持续静脉滴注联合化疗治疗晚期胃癌的临床疗效。方法 21例均为不能手术的Ⅳ期胃癌病人。均接受奥沙利铂130mg／m²，静滴2h，第1天；替加氟600mg／m²，经微量泵持续24h静脉输入，第1～5天，3～4周为一周期，连用2周期后，4周评价疗效。结果 21例患者中，CR0例，PR12例（57．1％），NC6例（28．6％），PD3例（14．3％），总有效率57．1％。中位缓解期4．6个月，中位生存期8．3个月，临床受益率85．7％。毒副反应主要是神经毒性、恶心、呕吐和腹泻等。结论 奥沙利铂与替加氟持续静脉滴注联合化疗治疗晚期胃癌可获得较高疗效，毒副反应能耐受，可作为晚期胃癌的有效治疗方案，值得进一步研究。     

Value of Combined Detection of Serum CEA,CA72-4, CA19-9 and TSGF in the Diagnosis of Gastric Cancer

Background: To explore whether combined detection of serum tumor markers (CEA, CA72-4, CA19-9 andTSGF) improve the sensitivity and accuracy in the diagnosis of gastric cancer (GC). Materials and Methods: Anautomatic chemiluminescence immune analyzer with matched kits were used to determine the levels of serumCEA, CA72-4, CA19-9 and TSGF in 45 patients with gastric cancer (GC group), 40 patients with gastric benigndiseases (GBD group) hospitalized in the same period and 30 healthy people undergoing a physical examination.The values of those 4 tumor markers in the diagnosis of gastric cancer was analyzed. Results: The levels ofserum CEA, CA72-4, CA19-9 and TSGF of the GC group were higher than those of the GBD group and healthyexamined people and the differences were significant (P<0.001). The area under receiver operating characteristic(ROC) curves for single detection of CEA, CA72-4, CA19-9 and TSGF in the diagnosis of GC was 0.833, 0.805,0.810 and 0.839, respectively. The optimal cutoff values for these 4 indices were 2.36 ng/mL, 3.06 U/mL, 5.72 U/mL and 60.7 U/mL, respectively. With combined detection of tumor markers, the diagnostic power of those 4indices was best, with an area under the ROC curve of 0.913 (95%CI 0.866~0.985), a sensitivity of 88.9% anda diagnostic accuracy of 90.4%. Conclusions: Combined detection of serum CEA, CA72-4, CA19-9 and TSGFincreases the sensitivity and accuracy in diagnosis of GC, so it can be regarded as the important means for earlydiagnosis.     

Stage Association of Preoperative Serum Carcinoembryonic Antigen with Gastric Adenocarcinoma in Iranian Patients

Background: Gastric cancer is the second leading cause of cancer-related mortality and the fourth most common cancer globally. Tumor markers are needed for appropriate management and monitoring of treatment to improve quality of life. Recently, carcinoembryonic antigen (CEA) has been widely used as a tumor marker in the diagnosis and follow-up of some malignancies. The aim of this study was to evaluate the significance of CEA detection in the course of disease in gastric cancer patients at different stages. Methods: Seventy six cases of gastric adenocarcinoma from the Rasht Razi Hospital were studied between January 2016 and December 2016, along with a control group of 152 people. Serum CEA was measured by ELISA reader. Statistical analysis was performed using SPSS 14.0 for Windows (SPSS Inc., Chicago, USA). The two groups were also compared by cross-table analysis using Pearson’s chi-square test, with P-values Results: CEA was positive in 61.8 % of patients versus 2.6% of the control group (P = 0.0001). Some 21% of patients at stages I and II (initial disease) and 40.8% at stages III and IV (advanced disease) demonstrated positive CEA. which was significantly correlated with higher N stage and poor differentiation. Conclusions: Our study showed that a high preoperative CEA level was not prevalent in early stage gastric cancer patients. We recommend to design other prospective studies and meta-analyses for elucidation of claims for diagnostic efficacy.     

A Case of Advanced Gastric Cancer With Long-Term Survival as the Results of Combined Radiation Therapy and Chemotherapy

A case report on a long-term surviving patient with advancedgastric cancer with supraclavicular lymph node metastasis treatedby radiation and chemotherapy is presented. The Borrman type 2 of advanced gastric cancer was found on thegreater curvature of the antrum at the first radiological examination. Radiation was administered to the supraclavicular lymph nodeat 60 Gy and to the stomach at 64 Gy. The patient received mitomycinC (24 mg) and Tegafur (230 g). After completion of the combinedtherapy the endoscopy revealed an irregular mucosal change witherosion and hemorrhage. Radiological examination revealed atrophicand hyperplastic areas throughout the stomach. These findingslasted more than six years. The patient died of unknown causein February 1983. She had survived nine years and seven monthsafter her initial diagnosis. Radiotherapy may play a role asa means of radical treatment in certain cases of advanced gastriccancer.