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Demircan NC, Atcı MM, Demir M, Işık S, Akagündüz B. Dynamic changes in systemic immune-inflammation index predict pathological tumor response and overall survival in patients with gastric or gastroesophageal junction cancer receiving neoadjuvant chemotherapy. Asia Pac J Clin Oncol 2023; 19:104-112. [PMID: 35538045 DOI: 10.1111/ajco.13784] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/05/2022] [Accepted: 04/06/2022] [Indexed: 01/20/2023]
Abstract
AIM Systemic inflammation has been associated with chemoresistance and prognosis in solid tumors. Systemic immune-inflammation index (SII) is a novel marker derived from complete blood count. We investigated whether differences between SIIs measured before and after neoadjuvant chemotherapy (NACT) are associated with tumor regression grade (TRG) and survival in gastric and gastroesophageal junction (GEJ) cancer patients. METHODS Records of gastric and GEJ cancer patients treated with NACT in two centers were evaluated retrospectively. Patients were categorized according to difference between pre- and post-NACT SII values (ΔSII). Association between clinicopathological factors and TRG was analyzed using logistic regression method. Predictors of disease-free and overall survival (DFS and OS) were determined with Cox regression models. RESULTS The study included 140 patients. Patients with ΔSII<0 were more likely to achieve TRG 0/1 (45.2% vs. 19.1%, p = 0.003) and ΔSII<0 was an independent predictor of TRG 0/1 (OR = 6.05, p<0.001). DFS and OS of patients with ΔSII<0 were also significantly longer (p = 0.031 and p = 0.006, respectively). After adjustment for other variables, ΔSII≥0 was an independent prognostic factor for OS (Hazard ratio (HR) = 2.13, p = 0.008). CONCLUSIONS Changes in SII, which is a low-cost and easily accessible marker, may be used to estimate prognosis, individualize postoperative treatment and optimize surveillance in gastric and GEJ cancer patients treated with NACT.
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Affiliation(s)
- Nazım Can Demircan
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, Prof. Dr. Cemil Taşçıoğlu State Hospital, Istanbul, Turkey
| | - Metin Demir
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Selver Işık
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Binali Yıldırım University School of Medicine, Erzincan, Turkey
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You W, Cai Z, Sheng N, Yan L, Wan H, Wang Y, Ouyang J, Xie L, Wu X, Wang Z. Construction and Validation of Convenient Clinicopathologic Signatures for Predicting the Prognosis of Stage I-III Gastric Cancer. Front Oncol 2022; 12:848783. [PMID: 35402221 PMCID: PMC8987912 DOI: 10.3389/fonc.2022.848783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Patients with stage I-III gastric cancer (GC) undergoing R0 radical resection display extremely different prognoses. How to discriminate high-risk patients with poor survival conveniently is a clinical conundrum to be solved urgently. Methods Patients with stage I-III GC from 2010 to 2016 were included in our study. The associations of clinicopathological features with disease-free survival (DFS) and overall survival (OS) were examined via Cox proportional hazard model. Nomograms were developed which systematically integrated prognosis-related features. Kaplan–Meier survival analysis was performed to compare DFS and OS among groups. The results were then externally validated by The Sixth Affiliated Hospital, Sun Yat-sen University. Results A total of 585 and 410 patients were included in the discovery cohort and the validation cohort, respectively. T stage, N stage, lymphatic/vascular/nerve infiltration, preoperative CEA, and CA19-9 were independent prognostic factors (P < 0.05). Two prognostic signatures with a concordance index (C-index) of 0.7502 for DFS and 0.7341 for OS were developed based on the nomograms. The 3-year and 5-year calibration curves showed a perfect correlation between predicted and observed outcomes. Patients were divided into three risk groups (low, intermediate, high), and distinct differences were noticed (p < 0.001). Similar results were achieved in the validation cohort. Notably, a free website was constructed based on our signatures to predict the recurrence risk and survival time of patients with stage I-III GC. Conclusions The signatures demonstrate the powerful ability to conveniently identify distinct subpopulations, which may provide significant suggestions for individual follow-up and adjuvant therapy.
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Affiliation(s)
- Weiqiang You
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou, China
| | - Zerong Cai
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou, China
| | - Nengquan Sheng
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Li Yan
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Huihui Wan
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, Institute for Genome and Bioinformatics, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China
| | - Yongkun Wang
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, Institute for Genome and Bioinformatics, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China
| | - Jian Ouyang
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, Institute for Genome and Bioinformatics, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China
| | - Lu Xie
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, Institute for Genome and Bioinformatics, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China
- *Correspondence: Zhigang Wang, ; Xiaojian Wu, ; Lu Xie,
| | - Xiaojian Wu
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou, China
- *Correspondence: Zhigang Wang, ; Xiaojian Wu, ; Lu Xie,
| | - Zhigang Wang
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Zhigang Wang, ; Xiaojian Wu, ; Lu Xie,
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Clinical importance of serum CEA and CA-19-9 levels in oesophagogastric junction adenocarcinomas. PRZEGLAD GASTROENTEROLOGICZNY 2021; 16:240-247. [PMID: 34584587 PMCID: PMC8456764 DOI: 10.5114/pg.2020.101911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 11/18/2020] [Indexed: 01/02/2023]
Abstract
Introduction In recent years, the incidence of gastroesophageal junction tumors has increased rapidly in worldwide. Aim To evaluate pretreatment serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 in oesophagogastric junction (OGJ) adenocarcinomas regarding clinicopathologic characteristics and overall survival. Material and methods Patients undergoing curative surgery diagnosed with OGJ adenocarcinoma in the gastrointestinal surgery clinic between 2007 and 2019 were included in the study retrospectively. Kaplan Meier and Log Rank tests were performed in survival analyses. Logistic regression analysis was performed to state the independent variables affecting survival. Results The mean age of the 70 patients included in the study was 59.78 ±10.49 (31–76) years. Serum CEA and CA 19-9 were high in 19 (27.1%) patients. CEA ≥ 5 ng/ml was found to be statistically significant in patients receiving neoadjuvant chemotherapy (NAC) and in patients with a high number of positive lymph nodes (N +) (p = 0.041 and p = 0.042, respectively). CA 19-9 positivity was statistically higher in patients with lymphovascular invasion (LVI) and diabetes mellitus (DM) (p = 0.042 and p = 0.012, respectively). The age and N+ findings of the patients in the CA 19-9-positive group were statistically significant compared to the patients in the CA 19-9-negative group (p = 0.039 and p = 0.007, respectively). Overall survival rates of 1–3 and 5 years were statistically significantly lower in patients who were CA 19-9 positive (p = 0.016). For patients in whom both tumour markers were positive, the N+ mean value was statistically significantly higher (p = 0.001). Conclusions In our study, a significant relationship was found in terms of overall survival and serum CA 19-9 in OGJ adenocarcinoma, and it was associated with both tumour markers being positive and the mean N+ value.
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Huang P, Lin L. Carbohydrate antigen 19‐9‐producing gastric carcinoma: A case report. ADVANCES IN DIGESTIVE MEDICINE 2021. [DOI: 10.1002/aid2.13200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Pi‐Teh Huang
- Division of Hepato‐Gastroenterology, Department of Internal Medicine Tungs' Taichung Metro‐Harbor Hospital Taichung Taiwan Republic of China
| | - Lien‐Fu Lin
- Division of Hepato‐Gastroenterology, Department of Internal Medicine Tungs' Taichung Metro‐Harbor Hospital Taichung Taiwan Republic of China
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Kim K, Yong SH, Lee SH, Lee SH, Leem AY, Kim SY, Chung K, Kim EY, Jung JY, Park MS, Kim YS, Lee HJ, Kang YA. Correlation between serum carbohydrate antigen 19-9 levels and computed tomography severity score in patients with nontuberculous mycobacterial pulmonary disease. Sci Rep 2021; 11:2777. [PMID: 33531571 PMCID: PMC7854612 DOI: 10.1038/s41598-021-82363-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/20/2021] [Indexed: 11/09/2022] Open
Abstract
There is no validated clinical biomarker for disease severity or treatment response for nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the correlation between elevated serum carbohydrate antigen (CA) 19-9 levels and NTM-PD disease activity, defined using an imaging severity score based on chest computed tomography (CT). We retrospectively examined 79 patients with NTM-PD who underwent serum CA19-9 level assessments and chest CT less than 1 month apart. NTM-PD severity was rated using a CT-based scoring system. The correlation between the CT score and serum CA19-9 levels was evaluated. Chest CT revealed nodular bronchiectasis without cavitation in most patients (78.5%). Serum CA19-9 levels were elevated in 19 (24%) patients. Serum CA19-9 levels were positively correlated with the total CT score and bronchiectasis, bronchiolitis, cavity, and consolidation subscores. Partial correlation analysis revealed a significant positive correlation between serum CA19-9 levels and CT scores for total score and bronchiectasis, bronchiolitis, cavitation, and consolidation subscores after controlling for age, sex, and BMI. Serum CA19-9 levels were positively correlated with the CT severity score for NTM-PD. Serum CA19-9 may be useful in evaluating disease activity or therapeutic response in patients with NTM-PD.
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Affiliation(s)
- Kangjoon Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hyun Yong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Hwan Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ah Young Leem
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Song Yee Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungsoo Chung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Ye Jung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Moo Suk Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Sam Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye-Jeong Lee
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Young Ae Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Institute of Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Study on the Diagnosis of Gastric Cancer by Magnetic Beads Extraction and Mass Spectrometry. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2743060. [PMID: 32802837 PMCID: PMC7426759 DOI: 10.1155/2020/2743060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/29/2020] [Accepted: 06/18/2020] [Indexed: 12/24/2022]
Abstract
Objective. This study constructed a model for the early diagnosis of gastric cancer by comparing the serum peptides profiles of patients with advanced gastric cancer and healthy people. And that model may be the potential to be applied for the efficacy evaluation and recurrence monitoring in gastric cancer. Methods. Serums of 30 healthy people and 30 advanced gastric cancer patients were matched by age and gender were collected. The serum peptide spectrum was obtained by MB-WCX concentration and MALDI-TOF MS analysis. Based on the analysis of the efficiency of differential peptides in the diagnosis of gastric cancer, we first established a model for the diagnosis of gastric cancer based on differential peptides and then carried out external verification. The diagnostic reliability of this model was further tested by compared with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). Results. In this present study, we found the expression of two peptide peaks with a molecular weight of 2863 Da and 2953 Da were significantly increased in gastric cancer serum, while the expression of two peptide peaks with a molecular weight of 1945 Da and 2082 Da were significantly decreased. Depending on the characteristics of peptide expression, we constructed a diagnostic model, we compared the sensitivity and specificity of the model established by 2953 Da/1945 Da, and found this model is significantly higher than CEA and CA19-9. Conclusion. There were some differences in serum peptides profiles between patients with advanced gastric cancer and healthy people. The serum peptide diagnostic models based on 2953 Da and 1945 Da have high diagnostic efficiency for advanced gastric cancer. Our result indicated that this model was well worth further validation for clinical diagnosis.
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Prognostic significance of pre- and post-operative tumour markers for patients with gastric cancer. Br J Cancer 2020; 123:418-425. [PMID: 32451469 PMCID: PMC7403417 DOI: 10.1038/s41416-020-0901-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/17/2020] [Accepted: 04/29/2020] [Indexed: 12/14/2022] Open
Abstract
Background In clinical practice, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 are the most common markers measured before and after surgery for gastric cancer (GC). However, which pre- or post-operative combined tumour markers (CEA and CA19-9) have more prognostic value remains unclear. Methods Consecutive patients undergoing a resection for GC at the Fujian Medical University Union Hospital were included as a discovery database between January 2011 and December 2014. The prognostic impact of pre- and post-operative tumour markers was evaluated using Kaplan–Meier log-rank survival analysis and multivariable Cox regression analysis. The results were then externally validated. Results A total of 735 and 400 patients were identified in the discovery cohort and in the validation cohort, respectively. Overall survival rates decreased in a stepwise manner in association with the number of pre- and post-operative positive tumour markers (both P < 0.001). Multivariable analysis revealed that the number of pre-operative positive tumour markers was an independent prognostic factor (P < 0.05). For patients with abnormal pre-operative tumour markers, normalisation of tumour markers after surgery is an independent prognostic protective factor (hazard ratio (HR) = 0.618; 95% confidence interval (CI) = 0.414–0.921), and patients with both positive post-operative tumour markers had double the risk of overall death (HR = 2.338; 95% CI = 1.071–5.101). Similar results were observed in the internal validation and external validation cohorts. Conclusion Pre-operative tumour markers have a better discriminatory ability for post-operative survival in GC patients than post-operative tumour markers, and the normalisation of tumour markers after surgery was associated with better survival.
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Kambara Y, Miyake H, Nagai H, Yoshioka Y, Shibata K, Asai S, Yuasa N. CA19-9 is a significant prognostic marker of patients with stage III gastric cancer. Eur J Surg Oncol 2020; 46:1918-1924. [PMID: 32814681 DOI: 10.1016/j.ejso.2020.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/18/2020] [Accepted: 05/05/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Due to prognostic heterogeneity within a stage of gastric cancer (GC), identification of patients with a high risk for recurrence after resection is important. We aimed to identify the prognostic significance of preoperative serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels in patients with Stage I, II, and III GC who underwent R0 gastrectomy. METHODS A total of 794 patients were included in this study after excluding 72 patients with CA19-9 <1.0 U/mL. Receiver operating characteristic curves were drawn to assess the optimal cut-off values of CEA and CA19-9 for disease recurrence. RESULTS The optimal cut-off values of CEA and CA19-9 levels were 2.9 ng/mL and 46.3 U/mL, respectively. Multivariate analysis for relapse-free survival (RFS) showed that stage of GC, CA19-9 levels, postoperative adjuvant chemotherapy, and venous invasion were significant independent factors. The RFS and overall survival (OS) of patients with CA19-9 ≥ 46.3 U/mL were significantly lower than those with CA19-9 < 46.3 U/mL in Stage III GC. However, the RFS of GC patients with CA19-9 ≥ 463 U/mL tended to be better than those with CA19-9 levels between 46.3 and 463 U/mL. CONCLUSIONS The RFS and OS of patients with CA19-9 ≥ 46.3 U/mL were significantly lower than those with CA19-9 < 46.3 U/mL in Stage III GC. However, there was no value dependency of extremely elevated CA19-9 on RFS. Further risk stratification can be obtained by measuring preoperative serum CA19-9 in stage III GC.
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Affiliation(s)
- Yuichi Kambara
- Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Hideo Miyake
- Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Hidemasa Nagai
- Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Yuichiro Yoshioka
- Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Koji Shibata
- Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Soichiro Asai
- Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan
| | - Norihiro Yuasa
- Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan.
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Kim YJ, Chung WC, Youn GJ, Jun KH, Chin HM. The predictive factors of gastric cancer recurrence after the completion of adjuvant chemotherapy in advanced gastric cancer. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2019; 111:537-542. [DOI: 10.17235/reed.2019.6041/2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ma WJ, Wu ZR, Shrestha A, Yang Q, Hu HJ, Wang JK, Liu F, Zhou RX, Li QS, Li FY. Effectiveness of additional resection of the invasive cancer-positive proximal bile duct margin in cases of hilar cholangiocarcinoma. Hepatobiliary Surg Nutr 2018; 7:251-269. [PMID: 30221153 DOI: 10.21037/hbsn.2018.03.14] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background The survival benefits of additional resection of the positive proximal ductal margin (PM) in hilar cholangiocarcinoma (HCCA) remains controversial. This retrospective study investigated the effectiveness of additional resection of the invasive cancer PM under different levels of preoperative carbohydrate antigen 19-9 (CA19-9). Methods Patients who underwent hepatectomy for HCCA from 2000 to 2017 were analyzed. Surgical variables, resection margin status, length of the PM (LPM), prognostic factors, and survival were evaluated. Results A total of 228 patients were enrolled: 175 PM(-) without additional resection patients (group A), 21 PM(-) after additional resection (group B), 16 PM(+) without additional resection (group C), and 16 PM(+) after additional resection (group D). The median survival of group B (20.99 months) was similar to that of group A (23.00 months; P=0.16), and both were significantly better than those of group C (11.60 months) and D (9.50 months), especially when preoperative CA19-9>150 U/mL (P<0.05). The survival of patients with an LPM >10 mm was significantly better compared with those with an LPM ≤10 mm, especially when preoperative CA19-9 was >150 U/mL (P<0.05). Only in the LPM >10 mm group, the survival of group B was comparable with that of group A (P>0.05). Conclusions HCCA patients could get a survival benefit from a negative PM resulting from additional resection. Survival could be comparable with that of negative PM without additional resection among HCCA patients. An LPM >10 mm is possibly more associated with better survival compared with whether additional resection of the positive PM is performed under different levels of preoperative CA19-9.
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Affiliation(s)
- Wen-Jie Ma
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhen-Ru Wu
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Anuj Shrestha
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of General Surgery, Andaki Medical College, Pokhara, Nepal
| | - Qin Yang
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hai-Jie Hu
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jun-Ke Wang
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Fei Liu
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Rong-Xing Zhou
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Quan-Sheng Li
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Fu-Yu Li
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Yoon HJ, Kim BS, Moon CM, Yoo J, Lee KE, Kim Y. Prognostic value of diffuse splenic FDG uptake on PET/CT in patients with gastric cancer. PLoS One 2018; 13:e0196110. [PMID: 29698422 PMCID: PMC5919642 DOI: 10.1371/journal.pone.0196110] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/08/2018] [Indexed: 01/26/2023] Open
Abstract
Background This study investigated the prognostic value of diffuse splenic uptake on F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in gastric cancer (GC) patients. Methods A total of 134 pathology confirmed GC patients who underwent PET/CT for staging work-ups were enrolled. The maximal standardized uptake value (SUVmax) of primary tumor (Tmax), spleen (Smax), and spleen to liver uptake ratio (SLR) were measured. The prognostic value of PET-measured parameters in GC patients for predicting recurrence-free survival (RFS) and overall survival (OS) were assessed. And the relationships of the parameters with hematological and inflammatory parameters were also investigated. Results During follow-up period, 19 patients (14.1%) had disease recurrence and 12 (8.9%) died from GC. In univariate analysis, hematocrit (p<0.001 and p = 0.002), neutrophil to lymphocyte ratio (NLR; p = 0.021 and p = 0.040), AJCC staging (p<0.001 and p<0.001), adjuvant chemotherapy (p<0.001 and p<0.001), Tmax (p = 0.004 and p = 0.005), and SLR (p = 0.005 and p = 0.016) were significant prognostic factors for RFS and OS, whereas platelet to lymphocyte ratio (PLR; p = 0.034) was a significant prognostic factor for RFS. In multivariate analysis, only SLR was an independent prognostic factor for RFS (p = 0.018, adjusted HR = 3.011, 95% CI = 1.207–7.511). SLR were significantly associated with serum hematocrit level (r = -0.256, p = 0.002), PLR (r = 0.362, p = 0.001), and Tmax (r = 0.280, p = 0.001). Conclusion Diffuse splenic uptake on FDG PET/CT was correlated with the level of hematological and inflammatory parameters and was an independent predictor for RFS in GC.
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Affiliation(s)
- Hai-Jeon Yoon
- Department of Nuclear Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Bom Sahn Kim
- Department of Nuclear Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- * E-mail: (BSK); (CMM)
| | - Chang Mo Moon
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Tissue Injury Defense Research Center, Ewha Womans University, Seoul, Republic of Korea
- * E-mail: (BSK); (CMM)
| | - Jang Yoo
- Department of Nuclear Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Ko Eun Lee
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yemi Kim
- Clinical Research Institute, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
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Zhang Q, Qu H, Sun G, Li Z, Ma S, Shi Z, Zhao E, Zhang H, He Q. Early postoperative tumor marker responses provide a robust prognostic indicator for N3 stage gastric cancer. Medicine (Baltimore) 2017; 96:e7560. [PMID: 28796039 PMCID: PMC5556205 DOI: 10.1097/md.0000000000007560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The clinical significance of tumor markers after radical gastrectomy has not been well characterized. The purpose of this study is to evaluate the prognostic value of early postoperative tumor marker normalization in N3 stage gastric cancer (GC) patients. A total of 259 N3 stage GC patients with preoperatively elevated carcinoembryonic antigen (CEA, >5 ng/mL) or carbohydrate antigen 19-9 (CA19-9, >37 U/mL) levels underwent radical gastrectomy were analyzed retrospectively. Early postoperative tumor marker response was considered as a normalization of CEA or CA19-9 levels 4 weeks after surgery. The disease-free survival (DFS) and overall survival (OS) were analyzed. N3 stage GC patients were divided into N3a (n = 157) and N3b (n = 102) groups according to the 8th TNM stage system. Early tumor marker response was identified in 96 of 157 N3a patients (61.15%) and 57 of 102 N3b patients (55.88%). In N3 stage GC patients with a tumor marker response, significant increase was observed in both DFS (25.2 months vs 12.5 months, P < .001) and OS (32.5 months vs 18.5 months, P < .001) compared with those without tumor marker response. N3b patients with a tumor marker response showed more favorable DFS (19.2 months vs 13.6 months, P = .019) and OS (25.8 months vs 19.0 months, P = .013) compared with N3a patients lacking a tumor marker response. Multivariate analysis revealed that early tumor marker response was an independent factor for DFS and OS in N3 stage GC, as well as for depth of invasion and metastatic lymph node rate (P < .05). Early postoperative CEA or CA19-9 normalization serves as a strong prognostic indicator in N3 stage GC. Both N3a and N3b patients with increased early postoperative tumor marker levels showed poor outcomes.
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Affiliation(s)
| | - Hui Qu
- Department of General Surgery
| | | | | | - Shuzhen Ma
- Department of Chemotherapy, Shandong University Qilu Hospital, Jinan
| | - Zhenxing Shi
- Department of General Surgery, The People's Hospital of Laoling, Dezhou, China
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Influence of prognostic nutritional index and tumor markers on survival in gastric cancer surgery patients. Langenbecks Arch Surg 2017; 402:501-507. [PMID: 28293741 DOI: 10.1007/s00423-017-1572-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 03/06/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE Blood analytes are easily used in routine clinical practice. Tumor markers (TMs) are useful in diagnosing, treating, and predicting prognosis of gastric cancer (GC). The prognostic nutritional index (PNI) was also recently found to be useful in predicting GC prognosis. METHODS The PNI and serum levels of CEA and CA19-9 of 453 patients with GC were measured to examine correlations between those levels and patients' prognoses. RESULTS Of the 453 patients, 84 (18.5%) were positive for CEA and/or CA19-9 and therefore considered positive for TMs. Prognosis of patients who were TM+ was significantly worse than for those who were TM-. Mean PNI was 48.2 (range 27.7-63.6). ROC analysis indicated that 46.7 was the optimal PNI cutoff value. Prognosis of patients in the PNILow group (<46.7) was significantly worse than in the PNIHigh group (≥46.7). Prognosis of patients who were both TM+ and PNILow was significantly worse than that of patients who were either TM+ or PNILow and those who were both TM- and PNIHigh. Multivariate analysis indicated that combination of TM and PNI was an independent prognostic indicator. CONCLUSIONS The combination of TM and PNI offers accurate information about a patient's prognosis.
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Selectin Ligands Sialyl-Lewis a and Sialyl-Lewis x in Gastrointestinal Cancers. BIOLOGY 2017; 6:biology6010016. [PMID: 28241499 PMCID: PMC5372009 DOI: 10.3390/biology6010016] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 12/20/2022]
Abstract
The tetrasaccharide structures Siaα2,3Galβ1,3(Fucα1,4)GlcNAc and Siaα2,3Galβ1,4(Fucα1,3)GlcNAc constitute the epitopes of the carbohydrate antigens sialyl-Lewis a (sLea) and sialyl-Lewis x (sLex), respectively, and are the minimal requirement for selectin binding to their counter-receptors. Interaction of sLex expressed on the cell surface of leucocytes with E-selectin on endothelial cells allows their arrest and promotes their extravasation. Similarly, the rolling of cancer cells ectopically expressing the selectin ligands on endothelial cells is potentially a crucial step favoring the metastatic process. In this review, we focus on the biosynthetic steps giving rise to selectin ligand expression in cell lines and native tissues of gastrointestinal origin, trying to understand whether and how they are deregulated in cancer. We also discuss the use of such molecules in the diagnosis of gastrointestinal cancers, particularly in light of recent data questioning the ability of colon cancers to express sLea and the possible use of circulating sLex in the early detection of pancreatic cancer. Finally, we reviewed the data dealing with the mechanisms that link selectin ligand expression in gastrointestinal cells to cancer malignancy. This promising research field seems to require additional data on native patient tissues to reach more definitive conclusions.
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Yu J, Zheng W. An Alternative Method for Screening Gastric Cancer Based on Serum Levels of CEA, CA19-9, and CA72-4. J Gastrointest Cancer 2016; 49:57-62. [DOI: 10.1007/s12029-016-9912-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Differences and correlation of serum CEA, CA19-9 and CA72-4 in gastric cancer. Mol Clin Oncol 2015; 4:441-449. [PMID: 26998301 DOI: 10.3892/mco.2015.712] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/27/2015] [Indexed: 12/20/2022] Open
Abstract
The sensitivity of three biomarkers, carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9 and CA72-4, in combination has been identified to be greater than that of any of the biomarkers considered in isolation in cases of gastric cancer (GC). However, the fundamental cause underlying this phenomenon remains to be fully elucidated. In the present study, the differences and correlation of these three biomarkers were investigated in patients with GC in order to determine how the three biomarkers in combination work more effectively compared with any of the biomarkers considered alone. The serum levels of CEA, CA19-9 and CA72-4 of 216 patients with gastric adenocarcinoma were analyzed on admission to hospital. The differences in positive rates and the serum levels of CEA, CA19-9 and CA72-4 were analyzed using the χ2 test and the non-parametric Wilcoxon two-sample test. Phi (f) correlation analysis was used to study the correlation among the expression (positive or not) levels of CEA, CA19-9 and CA72-4. The correlation among the serum levels of biomarkers was analyzed using Spearman's test. The results demonstrated that the combined positive rate of CEA, CA19-9 and CA72-4 was significantly higher compared with the individual CEA, CA19-9 and CA72-4 positive rates (44.91% vs. 22.69, 18.98 and 22.69%, respectively; all P<0.05). The positive rate of CA19-9 and CA72-4 in the extent of the primary tumor/involvement of regional lymph node/distant metastases (TNM)-III/IV stage subgroup was higher compared with that in the TNM-I/II subgroup (χ2=5.902, P=0.015; χ2=8.009, P=0.005), although not the positive rate of CEA (χ2=0.302, P=0.583). A significant correlation was identified between the expression level of CEA and CA72-4 (f correlation coefficient=0.182; P=0.008) and between that of CA19-9 and CA72-4 (f correlation coefficient=0.189; P=0.006), although not between that of CEA and CA19-9 (f correlation coefficient=0.048; P=0.482) in the total number of patients with GC. A significant correlation was also identified between the serum levels of CEA and CA19-9, of CEA and CA72-4 and of CA19-9 and CA72-4 (Spearman's correlation coefficient=0.231, -0.271 and 0.167; P=0.001, P<0.0001 and P=0.014, respectively). The present study indicated that there was only a weak correlation between the positive rate of CEA and CA72-4 and between that of CA19-9 and CA72-4, and no correlation was identified between the positive rate of CEA and CA19-9, even if a correlation was identified between the serum levels of the biomarkers. The present study suggested that the evidence that the sensitivity of the three biomarkers in combination is greater than that of any of the biomarkers taken in isolation is due to less co-presentation of CEA, CA19-9 and CA72-4 in patients with GC.
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Clinicopathologic and Prognostic Value of Serum Carbohydrate Antigen 19-9 in Gastric Cancer: A Meta-Analysis. DISEASE MARKERS 2015; 2015:549843. [PMID: 26576068 PMCID: PMC4631884 DOI: 10.1155/2015/549843] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/29/2015] [Indexed: 12/12/2022]
Abstract
Background. The clinical value of carbohydrate antigen (CA) 19-9 in gastric cancer is controversial. We evaluated the clinicopathologic and prognostic value of CA 19-9 in gastric cancer. Methods. A literature search was conducted in PubMed and Embase databases. Odds ratios (ORs), risk ratios (RR), hazard ratios (HRs), and 95% confidence intervals (CIs) were used as effect measures. Results. Thirty-eight studies were included. Results showed that there were significant differences in the incidence of high CA 19-9 levels between stages III/IV and I/II groups (OR = 3.36; 95% CI = 2.34–4.84), the pT3/T4 and pT1/T2 groups (OR = 2.40; 95% CI = 1.60–3.59), the lymph node-positive and node-negative groups (OR = 2.91; 95% CI = 2.21–3.84), the metastasis-positive and metastasis-negative groups (OR = 2.76; 95% CI = 1.12–6.82), and vessel invasion-positive and invasion-negative groups (OR = 1.66; 95% CI = 1.11–2.48). Moreover, CA 19-9 was significantly associated with poor overall survival (HR = 1.83; 95% CI = 1.56–2.15), disease-free survival (HR = 1.85; 95% CI = 1.16–2.95), and disease-specific survival (HR = 1.33; 95% CI = 1.10–1.60) in gastric cancer. Conclusions. Our meta-analysis showed that CA 19-9 indicates clinicopathologic characteristics of gastric cancer and is associated with a poor prognosis.
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Yin LK, Sun XQ, Mou DZ. Value of Combined Detection of Serum CEA, CA72-4, CA19-9 and TSGF in the Diagnosis of Gastric Cancer. Asian Pac J Cancer Prev 2015; 16:3867-70. [DOI: 10.7314/apjcp.2015.16.9.3867] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hu ZD, Huang YL, Qin BD, Tang QQ, Yang M, Ma N, Fu HT, Wei TT, Zhong RQ. Prognostic value of neutrophil to lymphocyte ratio for gastric cancer. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:50. [PMID: 25861605 DOI: 10.3978/j.issn.2305-5839.2015.03.26] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 03/02/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although the prognostic value of the neutrophil to lymphocyte ratio (NLR) in gastric cancer (GC) patients has been investigated by many studies, the results are heterogeneous. The objective of this systematic review is to ascertain the prognostic value of NLR in GC patients. METHODS PubMed and Embase were retrieved to identify potential studies published before 8 June, 2014. Newcastle-Ottawa Scale (NOS) for cohort study was used to assess the quality of all eligible studies. RESULTS Of the 20 studies included in this systematic review, 17 studies investigated the effect of NLR on overall survival (OS), 11 studies reported that NLR negatively affected OS in their multivariante analysis, and 16 studies reported that NLR negatively affected OS in univariate analysis. Three studies investigated the effect of NLR on progression-free survival (PFS), reporting that increased NLR was associated with worse PFS. Four studies investigated the effect of NLR on disease-free survival (DFS), two of which reported that increased NLR was associated with worse DFS. Two studies investigated the effect of NLR on disease special survival (DSS), but neither observed any significant association between NLR and DSS. The major design deficiencies of the studies available were retrospective data collection, inadequacy of follow-up cohorts, and unavailability of the method used for outcome assessment. CONCLUSIONS Based on the above findings, we conclude that NLR may be a useful prognostic index (PI) for GC. In addition, future studies with prospective design, long-term follow-up and fully adjusted confounding factors are needed to rigorously assess the prognostic value of NLR for GC.
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Affiliation(s)
- Zhi-De Hu
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Yuan-Lan Huang
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Bao-Dong Qin
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Qing-Qin Tang
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Min Yang
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Ning Ma
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Hai-Tao Fu
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Ting-Ting Wei
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
| | - Ren-Qian Zhong
- 1 Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China ; 2 Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan 250031, China ; 3 Department of Laboratory Medicine, No. 455 Hospital of Chinese People's Liberation Army, Shanghai 200052, China
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Oguro S, Esaki M, Kishi Y, Nara S, Shimada K, Ojima H, Kosuge T. Optimal indications for additional resection of the invasive cancer-positive proximal bile duct margin in cases of advanced perihilar cholangiocarcinoma. Ann Surg Oncol 2014; 22:1915-24. [PMID: 25404474 DOI: 10.1245/s10434-014-4232-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND The survival benefits of additional resection of the positive proximal ductal margin in cases of perihilar cholangiocarcinoma remain to be elucidated. The purpose of this retrospective study was to clarify the optimal indications for additional resection of the invasive cancer-positive proximal ductal margin (PM) METHODS: All patients who underwent hepatectomy for perihilar cholangiocarcinoma between 2000 and 2011 were analyzed. Surgical variables, the status of the PM, prognostic factors, and survival were evaluated. RESULTS A total of 224 patients were enrolled. Additional resection was performed in 52 of 75 positive PMs of invasive cancer, resulting in 43 negative PMs. The survival of patients with a negative PM treated with additional resection (n = 43) was significantly worse than that of the patients with a negative PM treated without additional resection (n = 149; P = 0.031) and did not significantly differ from that of the patients with a positive PM (n = 32; P = 0.215). A multivariate analysis demonstrated that the carbohydrate antigen 19-9 (CA19-9) level (<64 or ≥64), combined vascular resection, pN, pM, the histological grade, perineural invasion, liver invasion, and R status were independent prognostic factors. Only in the subgroups of CA19-9 < 64 and pM0, the survival of the patients with a negative PM treated with additional resection was significantly better than that of the patients with a positive PM (P = 0.019 and P = 0.021, respectively). CONCLUSIONS Additional resection of the invasive cancer-positive PMs may be warranted only in limited patients with a lower level of CA19-9 and no distant metastatic disease.
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Affiliation(s)
- Seiji Oguro
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
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Lim JB, Kim DK, Chung HW. Clinical significance of serum thymus and activation-regulated chemokine in gastric cancer: potential as a serum biomarker. Cancer Sci 2014; 105:1327-33. [PMID: 25154912 PMCID: PMC4462361 DOI: 10.1111/cas.12505] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 08/04/2014] [Accepted: 08/13/2014] [Indexed: 01/26/2023] Open
Abstract
Thymus and activation-regulated chemokine (TARC) can stimulate cancer cell proliferation and migration. The present study evaluated the clinical significance of serum TARC in gastric cancer (GC). We measured serum TARC, macrophage-derived chemokine, monocyte chemotactic protein-1 and stem cell factor (SCF) levels using a chemiluminescent immunoassay along the GC carcinogenesis (normal, high-risk, early GC [EGC] and advanced GC [AGC]) in both training (N = 25 per group) and independent validation datasets (90 normal, 30 high-risk, 50 EGC and 50 AGC). Serum levels were compared among groups using one-way analysis of variance. To evaluate the diagnostic potential of serum TARC for GC, receiver operating characteristic curve and logistic regression analyses were performed. Correlations between serum TARC and GC clinicopathological features were analyzed using Spearman's correlation. In the training dataset, serum TARC correlated with serum MDC, MCP-1 and SCF. However, only serum TARC and SCF were significantly higher in cancer groups than non-cancer groups (P < 0.001). In the validation dataset, serum TARC also increased along the GC carcinogenesis; the AGC group (167.2 ± 111.1 ng/mL) had significantly higher levels than the EGC (109.1 ± 67.7 ng/mL), the high-risk (66.2 ± 47.7 ng/mL) and the normal (67.5 ± 36.2 ng/mL) groups (Bonferroni, all P < 0.001). Receiver operating characteristic curves and logistic regression demonstrated the remarkable diagnostic potential of serum TARC as a single marker (72.0% sensitivity and 71.1% specificity; cutoff point, 0.37; logistic regression) and in a multiple-marker panel (72.6% sensitivity and 88.2% specificity; cutoff point, 0.54). Spearman's correlation showed that serum TARC was closely correlated with tumor size (γs = 0.227, P = 0.028), T-stage (γs = 0.340, P = 0.001), N-stage (γs = 0.318, P = 0.002) and M-stage (γs = 0.346, P = 0.001). Serum TARC is a promising serum biomarker for GC.
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Affiliation(s)
- Jong-Baeck Lim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
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Kim JY, Kim SH, Kim SY. Elevated serum CA 19-9 at screening tests: underlying conditions and role of abdominopelvic CT. Eur Radiol 2014; 24:2435-48. [PMID: 25113646 DOI: 10.1007/s00330-014-3262-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/30/2014] [Accepted: 05/22/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate underlying conditions of patients with elevated CA 19-9 at screening tests and to evaluate diagnostic performance of abdominopelvic CT. METHODS One hundred and thirteen patients with elevated CA 19-9 (>37 U/ml) who underwent abdominopelvic CT in a screening program were selected. Underlying conditions were determined by reviewing all available data and follow-up records. Patients were categorized into malignancy, benign, and normal/non-related disease groups. Their mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml were compared. Diagnostic sensitivity of CT for detecting underlying conditions of elevated CA 19-9 was analysed. RESULTS Seventeen patients (17/113, 15 %) had 17 elevated CA 19-9-related malignancies, and 55 patients (55/113, 48.7 %) had 70 benign diseases. Mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml in the malignancy group were significantly higher than in the two other groups. CT detected all except one malignant lesion with a detection sensitivity of 94.1 % (16/17). Of 70 CA 19-9-related benign diseases, CT detected 34 benign diseases (48.6 %) providing an alternative diagnosis for elevated CA 19-9. CONCLUSION Abdominopelvic CT is not only useful in detecting malignancies, but can also diagnose alternative benign causes of elevated CA 19-9 in asymptomatic screening tests. KEY POINTS • Fifteen percent of asymptomatic patients with elevated CA19-9 may have intra-abdominal malignancies. • Mean value of CA19-9 is different among malignant, benign, and non-related groups. • CT shows excellent sensitivity for intra-abdominal malignancies as causatives of elevated CA19-9. • CT provides alternative benign diagnoses as causatives of elevated CA19-9. • Detection of causatives of elevated CA19-9 using CT alleviates concerns and uncertainty.
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Affiliation(s)
- Ji Yang Kim
- Department of Radiology and Molecular Imaging Research Center, University of Louisville, Louisville, KY, USA
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Gwak HK, Lee JH, Park SG. Preliminary Evaluation of Clinical Utility of CYFRA 21-1, CA 72-4, NSE, CA19-9 and CEA in Stomach Cancer. Asian Pac J Cancer Prev 2014; 15:4933-8. [DOI: 10.7314/apjcp.2014.15.12.4933] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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