胃癌患者CEA与Ki-67的表达及意义

目的研究胃癌患者血清CEA水平及肿瘤组织中Ki-67的表达情况及与生物学行为和预后的关系。方法回顾性分析110例胃癌患者的血清CEA水平与肿瘤组织Ki-67表达情况，并分析两者与临床病理特征及预后的关系。结果血清CEA及胃癌组织Ki-67阳性率分别为37．27％、75．45％。血清CEA水平与胃癌浸润深度、淋巴结转移及TNM分期有关（P〈0．05），浸润至肌层以上、淋巴结阳性、TNM分期越高其阳性率越高。而Ki-67表达只与胃癌浸润深度有关（P〈0．05），随着浸润深度增加，Ki-67阳性率增高。两者在胃癌患者中的表达呈正相关（r=0．265，P〈0．05）。两者联合检测与胃癌浸润深度、淋巴结转移和TNM分期关系密切（P〈0．05），随着浸润深度、淋巴结转移数、TNM分期的增加，两者双阳性率增高。CEA阳性组、Ki-67阳性组的复发风险明显较高（P〈0．05）。CEA及Ki-67双阳性组患者的复发风险明显高于非双阳性组（P〈0．05）。结论联合检测血清CEA及肿瘤组织Ki-67可作为临床评价胃癌患者预后的指标。

Expression and Significance of CEA and Ki-67 in Gastric Carcinoma

Objective To investigate the expression and clinical significance of preoperative serum CEA level and postoperative Ki-67 in gastric cancer tissue. Methods The preoperative serum CEA level and postoperative Ki- 67 expression in gastric cancer tissues of 110 patients who previously received radical resection of gastric cancer were retrospectively assessed. The correlations between their expressions and clinical pathology features or prognosis were also analyzed. Results The positive rates of serum CEA and Ki-67 in gastric cancer tissue were 37.27% and 75.45%. The serum CEA was significantly associated with infiltration depth, regional lymph node metastasis and TNM stages （P 〈 0.05）, the patients with deeper infiltrating depth, more lymph nodes infiltrated and higher TNM stage tended to be serum CEA positive. The Ki-67 was correlated with tumor infiltration depth （ P 〈 0.05 ）, the Ki- 67 positive rate was higher in patients with deeper infiltrating depth. Serum CEA level in gastric cancer was positive- ly correlated with the Ki-67 expression （r = 0. 265 ,P 〈 0. 05 ）. Combined analysis of CEA and Ki-67 were correlated with infiltration depth, regional lymph node metastasis and TNM stages （P 〈 0.05 ）, with the increase of infiltrating depth, number of positive lymph nodes and TNM stages, the positive rate of both the CEA and Ki-67 was higher. The postoperative recurrence time of the CEA or Ki-67 positive group was shorter than that of the CEA or Ki-67 negative group（ P 〈0.05）. The recurrence time was significantly shorter in both of the serum CEA and Ki-67 positive group than those of the other groups. Conclusion Combined detection of the expression level of preoperative serum CEA and postoperative Ki-67 in gastric cancer tissue may be a predictive biomarker for the prognosis in patients with gas- tric cancer.