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目的 探讨外周血CEA和CA19-9等肿瘤标志物在胃癌侵袭转移、预后及新辅助化疗中的指导价值.方法 回顾性分析广州医学院附属肿瘤manbet官网登录 322例进展期胃癌患者的临床资料(其中54例接受新辅助化疗),采用电化学发光免疫分析检测外周血CEA和CA19-9等肿瘤标志物的表达,采用免疫组织化学方法检测新辅助化疗前后肿瘤组织CEA和CA19-9的表达.结果 外周血CEA和CA19-9表达与胃癌浸润深度、淋巴结转移以及肿瘤分期有关(均P＜0.05).外周血CEA表达阳性和阴性患者5年总体生存率分别为17.0％和34.6％,外周血CA19-9表达阳性和阴性患者5年总体生存率分别为11.9％和34.8％,差异均有统计学意义(均P＜0.05).新辅助化疗可明显降低胃癌组织中CEA和CA19-9蛋白的表达水平(P＜0.05),但对外周血CEA和CA19-9水平则无明显影响(P＞0.05).结论 外周血CEA和CA19-9表达水平与进展期胃癌的侵袭转移和预后有关；但对新辅助化疗患者筛选的价值有待进一步研究.

Objective To investigate the predictive value of CEA and CA19-9 in tumor progression,prognosis and neoadjuvant chemotherapy of advanced gastric cancer.Methods Clinical data of 322 patients with advanced gastric cancer(54 cases undergoing neoadjuvant chemotherapy) from the Affiliated Oncologic Hospital of Guangzhou Medical College were reviewed.Serum CEA and CA19-9 levels were detected by electrochemiluminescence immunoassay,while the expression of CEA and CA19-9 protein in 54 pairs of tumor tissues and matched biopsies neoadjuvant chemotherapy were determined by immunohistochemistry.Results The expression levels of serum CEA and CA19-9 were closely related to tumor invasion,lymph node metastasis and TNM stage (all P＜0.05).The 5-year cumulative survival rates of patients with serum CEA-positive and CA19-9-positive were 17.0％ and 11.9％,compared with 34.6％ and 34.8％ of the patients with serum CEA-negative and CA19-9-negative respectively (both P＜0.05).Neoadjuvant chemotherapy could down-regulate CEA and CA19-9 expressions in tumor tissues (P＜0.05),while there was no significantly difference in serum level (P＞0.05).Conclusions The expressions of serum CEA and CA19-9 are closely associated with tumor progression and prognosis in advanced gastric cancer.However,further study should be done to evaluate their value in selecting patients to receive neoadjuvant chemotherapy.