Predictive Value of Preoperative Serum CEA, CA19-9 and CA125 Levels for Peritoneal Metastasis in Patients with Gastric Carcinoma
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
PURPOSE: Peritoneal metastasis is a crucial factor for the prognosis in gastric cancer, but its diagnosis is difficult before laparotomy. This study analyzed the usefulness of diagnostic imaging and various tumor markers in the detection of peritoneal metastasis in gastric cancer. MATERIALS AND METHODS: The sera from 768 patients with gastric cancer were measured for CEA, CA19-9 and CA125 levels using a commercial immunoradiometric assay. All the patients underwent diagnostic imaging with computed tomography (CT) and ultrasound (US) before laparotomy. RESULTS: Preoperative levels of CEA, CA19-9 and CA125 were above the cut-off levels in 15.4%, 8.7% and 5.7% of all cases, respectively. Eighty-eight patients were diagnosed with peritoneal metastasis by laparotomy. CT and US revealed peritoneal dissemination in 15 of 88 patients (17%). Among the three tumor markers, CA19-9 and CA125 showed similar detection rates of peritoneal metastasis (37.5% and 38.6%, respectively). In particular, the serum CA125 levels showed the best sensitivity (38.6%), specificity (98.4%), and diagnostic accuracy (91.5%), and the highest odd ratio (24.46, 95% CI: 11.17~53.57) for predicting peritoneal metastasis among the markers tested. CEA did not add significant predictive information (p=0.471). CONCLUSION: Preoperative serum CA19-9 and CA125 levels may provide a predictable value in determining peritoneal metastasis in patients with gastric cancer. (Cancer Res Treat. 2004;36:178-181)
Abstract
PURPOSE: Peritoneal metastasis is a crucial factor for the prognosis in gastric cancer, but its diagnosis is difficult before laparotomy. This study analyzed the usefulness of diagnostic imaging and various tumor markers in the detection of peritoneal metastasis in gastric cancer. MATERIALS AND METHODS: The sera from 768 patients with gastric cancer were measured for CEA, CA19-9 and CA125 levels using a commercial immunoradiometric assay. All the patients underwent diagnostic imaging with computed tomography (CT) and ultrasound (US) before laparotomy. RESULTS: Preoperative levels of CEA, CA19-9 and CA125 were above the cut-off levels in 15.4%, 8.7% and 5.7% of all cases, respectively. Eighty-eight patients were diagnosed with peritoneal metastasis by laparotomy. CT and US revealed peritoneal dissemination in 15 of 88 patients (17%). Among the three tumor markers, CA19-9 and CA125 showed similar detection rates of peritoneal metastasis (37.5% and 38.6%, respectively). In particular, the serum CA125 levels showed the best sensitivity (38.6%), specificity (98.4%), and diagnostic accuracy (91.5%), and the highest odd ratio (24.46, 95% CI: 11.17~53.57) for predicting peritoneal metastasis among the markers tested. CEA did not add significant predictive information (p=0.471). CONCLUSION: Preoperative serum CA19-9 and CA125 levels may provide a predictable value in determining peritoneal metastasis in patients with gastric cancer. (Cancer Res Treat. 2004;36:178-181)
참고문헌 (18)
- "Intraoperative lavage for cytological examination in 1297patients with gastric carcinoma", 178, pp.256~262 (1999)
- "Serum CA125 level as apredictor of peritoneal dissemination in patients with gastriccarcinoma", 83, pp.2488~2500 (1998)
- "Carcinoembryonic antigenlevels in the peritoneal cavity:useful guide to peritonealrecurrence and prognosis for gastric cancer", 19, pp.133~137 (1995)
- "Trypsinogenexpression and early detection for peritoneal dissemination ingastric cancer", 69, pp.71~75 (1998)
- "The prognostic value ofpreoperative serum levels of CEA and CA19-9 in patients withgastric cancer", 91, pp.49~53 (1996)
- "Diagnostic value of tumor markers in stomach cancer", 31, pp.1094~1100 (1999)
- "Prognostic value ofpreoperative serum CEA and CA19-9 levels in gastric cancerpatients", 66, pp.27~32 (2004)
- "Tissue distribution of a coelomic-epitheliumrelatedantigen recognized by the monoclonal antibody OC125", 2, pp.273~285 (1983)
- "Ovariancancer antigen CA125:a prospective clinical assessment of itsrole as a tumor marker", 50, pp.765~769 (1984)
- "TNM Classification of MalignantTumors" (1997), Wiley-Liss
- "Japaneseclassification of gastric carcinoma" (1998), Kanehara
- "Diagnostic laparoscopy,serum CA125,and peritoneal metastasisin gastric cancer", 34, pp.569~574 (2002)
- "Selection of locallyadvanced gastric carcinoma by preoperative staging laparoscopy", 11, pp.1159~1162 (1997)
- "The usefulnessof CEA and", or Ca19-9 in monitoring for recurrence in gastriccancer patients:a prospective clinical study, 2003, pp.6, 142~145
- "Comparison of serumCA72-4, CEA, TPA, CA19-9 and CA125 levels in gastriccancer patients and correlation with recurrence", 49, pp.1157~1160 (2002)
- "Prognostic valueof carcinoembryonic antigen,CA19-9 and CA72-4 in gastriccarcinoma", 22, pp.318~322 (2001)
- "Cancerantigen 125 associated with multiple benign and malignantpathologies", 10, pp.150~154 (2003)
- "How tointerpret serum CA125 levels in patients with serosal involvement?A clinical dilemma", 65, pp.1~6 (2003)