甲胎蛋白阳性和癌胚抗原阳性胃癌的临床病理特征研究  

Clinicopathological characteristics of alpha fetal protein-positive and carcinoembryonic antigen-positive gastric cancer

作　　者：王刚[1] 马翔[1] 杨力[1] 徐泽宽[1] 徐皓[1] 张殿彩[1] 

机构地区：[1]南京医科大学第一附属医院普通外科,210029

出　　处：《中华实验外科杂志》2014年第12期2866-2869,共4页Chinese Journal of Experimental Surgery

基　　金：江苏省“科教兴卫”工程医学重点人才培养资助项目（RC201159）;江苏省“六大人才高峰人才”资助项目（2012）;江苏省科技厅基础研究计划（自然科学基金）（BK20131447）;“333高层次人才“工程”培养基金资助项目（BRA2013280）;江苏高校优势学科建设工程资助项目（IXl0231801）

摘　　要：目的 探讨甲胎蛋白（AFP）阳性,癌胚抗原（CEA）阳性胃癌患者临床病理特征及两者联合分析时与胃癌临床病理特征间的关系.方法 分析860例胃癌患者术前血清AFP阳性,CEA阳性者的临床病理特征.结果 与阴性者比较,AFP阳性患者病理分化程度更低（低分化者92.3％比69.5％）,分期更晚（Ⅲ＆#177;Ⅳ期88.5％比59.9％）,淋巴结阳性率更高（80.8％比59.1％）,更易浸润神经（46.2％比27.2％,P＜0.05）;CEA阳性患者病理分化程度更低（低分化者78.5％比70.4％）,肿瘤浸润层次更深（T4者84.1％比59.4％）,分期更晚（Ⅲ＋Ⅳ期78.5％比55.0％）,淋巴结阳性率更高（75.2％比54.5％）,更易浸润脉管（34.1％比21.0％）（P＜0.05）.联合分析,AFP（＋）-CEA（＋）、AFP（＋）-CEA（-）、AFP（-）-CEA（＋）、AFP（-）-CEA（-）在分化程度、临床分期、淋巴及脉管浸润方面差异有统计学意义（P＜0.05）.结论 术前血清AFP,CEA阳性与胃癌临床病理密切相关.Objective To evaluate the clinicopathological characteristics of alpha fetal protein （AFP）-positive gastric cancer and carcinoembryonic antigen （CEA）-positive gastric cancer,and combined effect of AFP and CEA on clinicopathological characteristics of gastric cancer.Methods 860 patients with gastric cancer in total were reviewed and the relationship between serum AFP and CEA with clinicopathological factors was analyzed.Results There was poorer differentiation （poor differentiation 92.3% vs.69.5%）,more advanced clinical stage （Ⅲ ＋ Ⅳ stage 88.5% vs.59.9%）,more marked lymphatic （80.8% vs.59.1%） and nerve invasion （46.2% vs.27.2%） in AFP-positive gastric cancer patients than in the negative group （P 〈 0.05）.Compared with CEA-negative gastric cancer patients,the CEApositive patients with poorer differentiation （poor differentiation 78.5% vs.70.4%）,deeper depth of invasion （T4,84.1% vs.59.4%）,more advanced clinical stage （m ＋ Ⅳ stage 78.5% vs.55.0%）,more marked lymphatic （75.2% vs.54.5%） and vascular invasion （34.1% vs.21.0%） （P 〈 0.05）.The result of combined analysis showed that there was significant difference among AFP （＋）-CEA （＋）,AFP （＋）-CEA （-）,AFP （-）-CEA （＋）,and AFP （-）-CEA （-） （P〈0.05）.Conclusion The clinicopathological features of AFP-positive or CEA-positive gastric cancer patients were quite different from the negative group.

关 键 词：甲胎蛋白 癌胚抗原 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]