DOI QR코드

DOI QR Code

Impact of Various Tumor Markers in Prognosis of Gastric Cancer -A Hospital Based Study from Tertiary Care Hospital of Kathmandu Valley

  • Mittal, Ankush (Department of Biochemistry, Nepalese Army Institute of Health Sciences) ;
  • Gupta, Satrudhan Pd. (Department of Biochemistry, Nepalese Army Institute of Health Sciences) ;
  • Jha, Dipendra Kumar (Department of Biochemistry, Nepalese Army Institute of Health Sciences) ;
  • Sathian, Brijesh (Department of Community Medicine, Manipal College of Medical Sciences) ;
  • Poudel, Bibek (Department of Biochemistry, Manipal College of Medical Sciences)
  • 발행 : 2013.03.30

초록

Background: To obtain the maximum additional information about the prognosis of gastric cancer, we compared CA-50 with other previously defined markers. Materials and Methods: This hospital based study was carried out in the Department of Biochemistry of Nepalese Army Institute of Health Sciences between $1^{st}$ July 2012 and $31^{st}$ December 2012. The variables collected were age, gender, AFP, CEA, CA19-9, and CA50, assayed with ELISA reader for all cases. The cut off values for serum AFP, CEA, CA19-9, and CA-50 were 10 ${\mu}g/l$, 10 ${\mu}g/l$, 37 U/ml, and 20 U/ml, respectively according to the manufacturer's instructions. Approval for the study was obtained from the institutional research ethical committee. Results: Of the 40 examined patients, 13 patients had tumors located in the upper third of the stomach, 6 patients had tumors in the middle third, 16 patients had tumors in the lower third, and 5 patients had tumors occupying two-thirds of the stomach or more. The distribution of lymph node staging of the patients was as follows: 7 patients belonged to N0, 9 patients to N1 stage, 10 patients to N2 stage, and 14 patients to N3 stage. The statistical method of Cox proportional hazards using multivariate analysis also illustrated that tumor markers including CEA (2.802), CA19-9 (2.690), CA50 (2.101), were independent prognostic factors, as tumor size (1.603), and lymph node stage (1.614). Conclusions: The tumour markers now available, like CEA, CA 19-9 and CA 50, chiefly perceive advanced gastric cancer. The preoperative rise in those tumour marker level have a prognostic significance and may be clinically helpful in choosing patients for adjuvant management.

참고문헌

  1. Sun Z, Wang ZN, Zhu Z, et al (2012). Evaluation of the seventh edition of American joint committee on cancer TNM staging system for gastric cancer: results from a Chinese monoinstitutional study. Ann Surg Oncol, 19, 1918-27. https://doi.org/10.1245/s10434-011-2206-1
  2. Zagari RM, Bazzoli F (2004). Gastric cancer: who is at risk? Dig Dis, 22, 302-5. https://doi.org/10.1159/000083590
  3. Dikshit RP, Mathur G, Mhatre S, et al (2011). Epidemiological review of gastric cancer in India. Indian J Med Paediatr Oncol, 32, 3. https://doi.org/10.4103/0971-5851.81883
  4. Herberman RB (1977). Immunologic tests in diagnosis of cancer. Am J Clin Pathol, 68, 688-98.
  5. Ishigami S, Natsugoe S, Hokita S, et al (2001). Clinical importance of preoperative carcinoembryonic antigen and carbohydrate antigen 19-9 levels in gastric cancer. J Clin Gastroenterol, 32, 41-4. https://doi.org/10.1097/00004836-200101000-00010
  6. Kaplan EL, Meier P (1958). Nonparametric estimation from incomplete observations. J Am Stat Assoc, 53, 457-81. https://doi.org/10.1080/01621459.1958.10501452
  7. Jager KJ, van Dijk PC, Zoccali C, et al (2008). The analysis of survival data: the kaplan-meier method. Kidney Int, 74, 560-5. https://doi.org/10.1038/ki.2008.217
  8. Kato K, Taniguchi M, Kawakami T, et al (2011). Gastric Cancer with a Very High Serum CA 19-9 Level. Case Rep Gastroenterol, 5, 258-61. https://doi.org/10.1159/000327984
  9. Kodera Y, Yamamura Y, Torii A, et al (1996). The prognostic value of preoperative serum levels of CEA and CA19-9 in patients with gastric cancer. Am J Gastroenterol, 91, 49-53.
  10. Kokociñska D, Jarzab B, Król R, et al (1996). A comparison of the clinical usefulness of CA 19-9 and CA 50 in the diagnosis and monitoring of gastrointestinal cancers. J Environ Pathol Toxicol Oncol, 15, 283-7.
  11. Kono K, Amemiya H, Sekikawa T (2002).Clinicopathologic features of gastric cancers producing alpha-fetoprotein. Dig Surg, 19, 359-65. https://doi.org/10.1159/000065838
  12. Kuusela P, Haglund C, Roberts PJ, et al (1987). Comparison of CA-50, a new tumour marker, with carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) in patients with gastrointestinal diseases. Br J Cancer, 55, 673-6. https://doi.org/10.1038/bjc.1987.137
  13. Schauer M, Peiper M, Theisen J, et al (2011). Prognostic factors in patients with diffuse type gastric cancer (linitis plastica) after operative treatment. Eur J Med Res, 16, 29-33. https://doi.org/10.1186/2047-783X-16-1-29
  14. Sipponen P, Kekki M, Siurala M(1988). Increased risk of gastric cancer in males affects the intestinal type of cancer and is independent of age, location of the tumour and atrophic gastritis. Br J Cancer, 57, 332-6. https://doi.org/10.1038/bjc.1988.75
  15. Bertuccio P, Chatenoud L, Levi F, et al (2009). Recent patterns in gastric cancer: a global overview. Int J Cancer, 125, 666-73. https://doi.org/10.1002/ijc.24290
  16. Cox DR (1972). Regression models and life-tables. J R Stat Soc B, 34, 187-220.

피인용 문헌

  1. CEA and CA 19-9 are Still Valuable Markers for the Prognosis of Colorectal and Gastric Cancer Patients vol.14, pp.7, 2013, https://doi.org/10.7314/APJCP.2013.14.7.4289
  2. Combined Detection of CEA, CA 19-9, CA 242 and CA 50 in the Diagnosis and Prognosis of Resectable Gastric Cancer vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6295
  3. Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis vol.16, pp.3, 2015, https://doi.org/10.7314/APJCP.2015.16.3.853
  4. Alpha-fetoprotein (AFP) Elevation Gastric Adenocarcinoma and Importance of AFP Change in Tumor Response Evaluation vol.16, pp.5, 2015, https://doi.org/10.7314/APJCP.2015.16.5.2003
  5. Differences and correlation of serum CEA, CA19-9 and CA72-4 in gastric cancer vol.4, pp.3, 2015, https://doi.org/10.3892/mco.2015.712
  6. A case report of targeted therapy with apatinib in a patient with advanced gastric cancer and high serum level of alpha-fetoprotein vol.95, pp.37, 2016, https://doi.org/10.1097/MD.0000000000004610