文章摘要
韩建波,骆大葵,杨 力,黄 驰,还向坤,王悠南,徐泽宽.术前血清CA19-9阳性和AFP阳性的胃癌患者临床病理研究[J].南京医科大学学报,2017,(8):1010~1014
术前血清CA19-9阳性和AFP阳性的胃癌患者临床病理研究
Analysis of clinicopathological characteristics of gastric cancer patients with serum CA19-9-positive and AFP-positive perioperatively
投稿时间:2016-12-13  
DOI:10.7655/NYDXBNS20170818
中文关键词: 糖链抗原19-9  甲胎蛋白  胃癌
英文关键词: carbohydrate antigen 19-9  alpha-fetoprotein  gastric cancer
基金项目:江苏省“科教兴卫”工程医学重点人才培养项目(RC201159);江苏省自然科学基金(BK20131447);江苏省“333高层次人才培养工程”(BRA2013280);江苏高校优势学科建设工程(IX10231801)
作者单位
韩建波 南京医科大学第一附属医院胃外科江苏 南京 210029 
骆大葵 南京医科大学第一附属医院胃外科江苏 南京 210029 
杨 力 南京医科大学第一附属医院胃外科江苏 南京 210029 
黄 驰 南京医科大学第一附属医院胃外科江苏 南京 210029 
还向坤 南京医科大学第一附属医院胃外科江苏 南京 210029 
王悠南 南京医科大学第一附属医院胃外科江苏 南京 210029 
徐泽宽 南京医科大学第一附属医院胃外科江苏 南京 210029 
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中文摘要:
      目的:探讨术前血清糖链抗原19-9(CA19-9)阳性和(或)甲胎蛋白(AFP)阳性的胃癌患者临床病理特征,及两者联合分析与胃癌的临床病理之间的联系。方法:回顾性分析南京医科大学第一附属医院900例术前检测血清CA19-9和AFP水平的胃癌患者临床病理资料。结果:与CA19-9阴性者相比,CA19-9阳性患者T分期更晚(T4期,94.2% vs. 65.5%),临床分期更晚(Ⅲ+Ⅳ期,89.2% vs. 61.5%),淋巴结转移率更高(80% vs. 61.3%),脉管和神经侵犯比例更高(32.5% vs. 23.3%;42.5% vs. 27.1%),差异有统计学意义(P<0.05);与AFP阴性者相比,AFP阳性患者临床分期更晚(Ⅲ+Ⅳ期,88.9% vs. 60.6%),淋巴结转移率更高(81.5% vs. 59.1%),更容易发生神经侵犯(44.4% vs. 27.0%),差异有统计学意义(P<0.05)。与CA19-9和AFP均阴性的患者相比,一种或两种肿瘤指标阳性的患者T分期更晚,临床分期更晚,淋巴结转移率更高,更容易出现脉管和神经侵犯(P<0.05)。二元Logistic回归多变量分析显示CA19-9阳性是影响胃癌侵犯深度的独立危险因素;与CA19-9(-)-AFP(-)比较,CA19-9(+)-AFP(+)是影响胃癌脉管浸润的独立危险因素,CA19-9(+)-AFP(-)是影响胃癌侵犯深度的独立危险因素(P<0.05)。结论:术前血清CA19-9和AFP水平与胃癌临床病理密切相关,术前检测其水平有助于为胃癌患者临床病理特征提供信息。
英文摘要:
      Objective: To evaluate the clinicopathological characteristics of gastric cancer patients with perioperative serum carbohydrate antigen 19-9 (CA19-9)-positive and alpha-fetoprotein (AFP)-positive, and combined effect of perioperative serum CA19-9 and AFP on clinicopathological characteristics of gastric cancer patients. Methods: The clinicopathological characteristics of 900 gastric cancer patients with serum CA19-9 and AFP detection perioperatively from the First Affiliated Hospital of NJMU were analyzed retrospectively. Results: Patients with elevated serum CA19-9 had the characteristics of more advanced T stage (T4 stage, 94.2% vs. 65.5%), later clinical stage (Ⅲ+Ⅳstage ,89.2% vs. 61.5%), more common lymph node metastasis (81.5% vs. 59.1%) and more remarkable vascular as well as neural invasion compared with those with normal level of serum CA19-9 (32.5% vs. 23.3%; 42.5% vs. 27.1%); Compared with AFP-negative patients, the AFP-positive patients suffered later clinical stage (Ⅲ+Ⅳstage ,88.9% vs. 60.6%), more common lymph node metastasis (81.5% vs. 59.1%) and more marked neural invasion (44.4% vs. 27.0%) (P<0.05). Patients with one or two positive tumor markers suffered more advanced T stage, later clinical stage, more common lymph node metastasis and more remarkable vascular as well as neural invasion compared with those with double-negative tumor markers (P<0.05). Two-category logistic regression analysis showed that CA19-9(+) was the independent risk factor for GC T stage; compared with CA19-9(-)-AFP(-), CA19-9(+)-AFP(+) was the independent risk factor for GC vascular invasion, CA19-9(+)-AFP(-) was the independent risk factor for GC T stage (P<0.05). Conclusion: Perioperative serum levels of CA19-9 and AFP are closely correlated with clinicopathological features for patients with gastric cancer, and the two tumor markers are highly recommended detecting perioperatively for offering information of clinicopathological characteristics.
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