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Brit J Cancer:胃癌患者术前和术后肿瘤标志物的预后意义

2020-05-26 MedSci原创 MedSci原创

术前肿瘤标志物对GC患者的术后生存具有比术后肿瘤标志物更好的区分能力,并且肿瘤标志物在术后正常化与更好的患者生存相关。

在临床实践中,癌胚抗原(CEA)和CA19-9是胃癌(GC)手术前后最常测量的标志物。但是,尚不清楚术前或术后联合肿瘤标志物(CEA和CA19-9)是否具有更大的预后价值。

近日,肿瘤领域权威杂志British Journal of Cancer上发表了一篇研究文章,在2011年1月至2014年12月期间,研究人员将在福建医科大学协和医院接受GC切除术的连续就诊的患者纳入发现数据库,并使用Kaplan–Meier对数秩生存分析和多变量Cox回归分析评估术前和术后肿瘤标志物对患者预后影响。然后对结果进行外部验证。

在发现队列和验证队列中分别确定了735名和400名患者。总体生存率与术前和术后阳性肿瘤标志物数量呈逐步降低关系(所有P<0.001)。多变量分析显示,术前阳性肿瘤标志物的数量是独立的预后因素(P<0.05)。对于术前肿瘤标志物异常的患者,术后肿瘤标志物的正常化是独立的预后保护因素(风险比(HR)=0.618; 95%置信区间(CI)=0.414-0.921),且术后肿瘤标志物两者均阳性的患者总死亡风险翻倍(HR=2.338; 95%CI=1.071-5.101)。在内部验证和外部验证队列中观察到了相似的结果。

由此可见,术前肿瘤标志物对GC患者的术后生存具有比术后肿瘤标志物更好的区分能力,并且肿瘤标志物在术后正常化与更好的患者生存相关。

原始出处:

Jun-Peng Lin.et al.Prognostic significance of pre- and post-operative tumour markers for patients with gastric cancer.British Journal of Cancer.2020.https://www.nature.com/articles/s41416-020-0901-z

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