위암환자에서 수술 전 후 혈청 CEA와 CA19-9 측정의 임상적 의의

Abstract

Although serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 are commonly measured before and after surgery for gastric cancer, the clinical significance of these tumor markers is not fully understood. This clinical study was performed to evaluate the prognostic value of these tumor markers in resectable gastric carcinoma. A retrospective analysis of 889 gastric cancer patients who had undergone curative gastrectomy between January 1997 and December 2001 at the Department of Surgery in Dongsan Medical Cencer was performed. We analyzed correlation between CEA or CA19-9 and clinicopathologic features, and estimated the prognostic value of the tumor markers by analyzing clinicopathologic characteristics of the carcinoma as a function of seropositivity or negativity of the antigens in combination. Serum CEA positivity significantly correlated with depth of invasion (P<0.01) and stage (P<0.05). Serum CA19-9 positivity significantly correlated with depth of invasion (P<0.001), nodal metastasis (P<0.001), tumor size (P<0.01) and stage (P<0.001). There were statistically significant correlations with stage (P<0.001), depth of invasion (P<0.001) and nodal metastasis (P<0.001) in the combined assay. Surgical outcomes of patients who were CEA and CA19-9 positive were poorer than those of patients with normal CEA and CA19-9 levels (P<0.001). In multivariate analysis, these tumor markers were not independent prognostic factors. The combined assay of CEA and CA19-9 serum levels provides prognostic information in gastric cancer patients. The serial postoperative assay of serum CEA and CA19-9 levels has predictability with regard to survival.