Proposal of the Second Cutoff of Serum Carcinoembryonic Antigen Levels to Stratify Patients into Low, Intermediate, and High Risks at Recurrences after Curative Resection of Gastric Cancer.

IF 1.8 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Digestive Surgery Pub Date : 2023-01-01 Epub Date: 2023-09-12 DOI:10.1159/000533143
Bin Sato, Mitsuro Kanda, Seiji Ito, Yoshinari Mochizuki, Hitoshi Teramoto, Kiyoshi Ishigure, Toshifumi Murai, Takahiro Asada, Akiharu Ishiyama, Hidenobu Matsushita, Koki Nakanishi, Dai Shimizu, Chie Tanaka, Michitaka Fujiwara, Kenta Murotani, Yasuhiro Kodera
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引用次数: 0

Abstract

Introduction: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 are widely used for treating various cancers, with cutoff values of 5.0 ng/mL and 37.0 IU/mL, respectively. However, these cutoff values are not for specific diseases or purposes but are uniformly used for any disease and any purpose. It is also unclear as to whether patients are at equal risk of recurrence if they are below the cutoff values. This study aimed to investigate the optimal cutoff of serum tumor markers in the stratification of recurrence risk after curative resection of gastric cancer.

Methods: We constructed a nine-center integrated database of patients who received gastrectomy between January 2010 and December 2014 with a 5-year follow-up period. We determined the cutoff value of preoperative serum tumor marker levels correlated with postoperative recurrences and evaluated its performance in risk stratification for recurrences in 948 patients with stage II/III gastric cancer who underwent radical resection.

Results: The hazard ratio for postoperative recurrences increased at two points of preoperative CEA levels, 3.6 ng/mL and 5.0 ng/mL, which were set as cutoffs. These two cutoffs stratified relapse-free survival into three levels.

Conclusions: By adding a second cutoff value for preoperative serum CEA, which was proposed specifically for the prediction of recurrences, patients can be stratified into low-, intermediate-, and high-risk recurrences after curative resection of gastric cancer.

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建议用血清癌胚抗原水平的第二个临界值将胃癌根治性切除术后复发的患者分为低、中、高风险。
导言:癌胚抗原(CEA)和碳水化合物抗原 19-9 被广泛用于治疗各种癌症,其临界值分别为 5.0 纳克/毫升和 37.0 IU/毫升。然而,这些临界值并非针对特定疾病或目的,而是统一用于任何疾病和任何目的。此外,目前还不清楚低于临界值的患者是否具有同等的复发风险。本研究旨在探讨血清肿瘤标志物在胃癌根治性切除术后复发风险分层中的最佳临界值:我们建立了一个九个中心的综合数据库,收录了 2010 年 1 月至 2014 年 12 月间接受胃切除术的患者,随访期为 5 年。我们确定了与术后复发相关的术前血清肿瘤标志物水平的临界值,并评估了其在对948例接受根治性切除术的II/III期胃癌患者进行复发风险分层时的表现:术前CEA水平在3.6纳克/毫升和5.0纳克/毫升这两个临界点时,术后复发的危险比增加。这两个临界值将无复发生存率分为三个等级:通过增加术前血清CEA的第二个临界值(该临界值是专门为预测复发而提出的),可将胃癌根治性切除术后复发的患者分为低、中、高三个风险等级。
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来源期刊
Digestive Surgery
Digestive Surgery 医学-外科
CiteScore
4.90
自引率
3.70%
发文量
25
审稿时长
3 months
期刊介绍: ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.
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