위암 환자에서 수술 전 혈청 CEA와 CA19-9 측정의 임상적 의의
Prognostic Value of Preoperative Serum CEA and CA19-9 Levels in Gastric Cancer Patients
백성욱, 조동호, 류창학, 한원곤,
소속 상세정보
백성욱 ( Baek Sung-Wook )
성균관대학교 의과대학 강북삼성병원 외과학교실
조동호 ( Cho Dong-Ho )
성균관대학교 의과대학 강북삼성병원 외과학교실
류창학 ( Yoo Chang-Hak )
성균관대학교 의과대학 강북삼성병원 외과학교실
한원곤 ( Han Won-Kon )
성균관대학교 의과대학 강북삼성병원 외과학교실
KMID : 0371320040660010027
Abstract
Purpose: The clinical significance of preoperative serum levels of tumor markers CEA and CA19-9 was evaluated in gastric cancer patients.
Methods: Serum levels of CEA and CA19-9 were measured in 1,310 patients with gastric cancer who underwent laparotomies over a recent 10-year period (1992~2001). The correlations between the serum levels of tumor markers and several clinicopathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factor was assessed by multivariate analysis.
Results: The positivity rates of CEA and CA19-9 were 17.5% and 13.4%, respectively. The positivity rate of CEA was higher in the elderly, in male patients, and in those with histologically differentiated tumors, whereas CA19-9 positivity was related to tumor location. In addition, the positivity rates of each tumor marker were significantly correlated with tumor size, gross type, depth of invasion, lymph node metastasis, peritoneal and liver metastases, and cancer stage. A significant difference in survival was observed between patients positive and negative for CEA and CA19-9. The multivariate analysis showed that in addition to gross type, depth of invasion, lymph node metastasis, peritoneal and liver metastasis, preoperative serum CEA and CA19-9 levels among those undergoing However, multivariate analysis of curatively resected cases identified gross type, depth of invasion, lymph node metastasis, and CA19-9 as significant prognostic variables.
Conclusion: Preoperative serum CEA and CA19-9 determination in patients with gastric cancer is of value for the prediction of tumor progression and prognosis. However, serum CA19-9 level was more useful than CEA as a prognostic factor in patients undergoing curative resection.
키워드
CEA;CA19-9;종양표지자;위암;예후;Carcinoembryonic antigen;Tumor marker;Gastric cancer;Prognosis
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