Early prediction of tumor recurrence after curative resection of gastric carcinoma by measuring soluble E-cadherin

被引:33
作者
Chan, AOO
Chu, KM [1 ]
Lam, SK
Cheung, KL
Law, S
Kwok, KF
Wong, WM
Yuen, MF
Wong, BCY
机构
[1] Univ Hong Kong, Queen Mary Hosp, Dept Med, Pokfulam, Hong Kong, Peoples R China
[2] Univ Hong Kong, Med Ctr, Queen Mary Hosp, Dept Surg, Pokfulam, Hong Kong, Peoples R China
关键词
carcinoembryonic antigen; gastric carcinoma; recurrence; tumor marker;
D O I
10.1002/cncr.21260
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND. Currently, to the authors' knowledge, there is no serum marker to predict disease recurrence after patients undergo curative resection for gastric carcinoma. Previous reports have indicated that serum levels of soluble E-cadherin had prognostic value in these patients. The objective of the current study was to determine whether soluble E-cadherin levels could predict disease recurrence in patients with gastric carcinoma who underwent curative surgery. METHODS. Sixty-nine patients who under-went curative surgery for gastric carcinoma after December 1997 were followed prospectively. Venous blood samples were collected preoperatively, 1 month after surgery, and every 3 months thereafter. The blood samples were assayed for soluble E-cadherin and for carcinoembryonic antigen (CEA) using commercial enzyme-linked immunosorbent assay kits. Receiver operating characteristic (ROC) curves were used to define a cut-off level of E-cadherin for the optimal sensitivity and specificity for predicting disease recurrence. RESULTS. The median follow-tip was 21 months for patients with recurrent disease (it 17 patients) and 36 months for patients without recurrent disease (n = 52 patients; P = 0.007). The optimal cut-off level of E-cadherin was 10,000 ng/mL. The sensitivity for predicting prediction disease recurrence using this cut-off level at 3 months and at 6 months postsurgery was 47% and 59% respectively, which was significantly better compared with the sensitivity of CEA using the conventional cut-off level (6% at 3 months postsurgery and 6% at 6 months postsurgery; P = 0.004 and P < 0.0001, respectively). The median time between the elevated E-cadherin level and documented disease recurrence was 13 months (range, 3-20 months), compared with 4 months (range, 1-20 months) for CEA. CONCLUSIONS. Serum soluble E-cadherin was a good marker for predicting disease recurrence in the first 3-6 months after surgery, with a median of 13 months before clinical recurrence. The use of this marker may allow time for vigilant surveillance and consideration of adjuvant therapy.
引用
收藏
页码:740 / 746
页数:7
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