Metastatik mide kanserinde karsinoembriyonik antijen (cea) prediktif midir?

Giriş: Mide kanseri dünya genelinde kanser sıklığında beşinci sırada, kansere bağlı ölümlerde de dördüncü sıradadır. Karsinoembriyonik antijen (CEA) mide kanserinin takibinde sıklıkla kullanılan bir tümör markeridir. Daha önce prognostik yönü çok çalışılmış olan bu markerin tedaviyi belirleyici (prediktif) yönünü araştırmak amacıyla çalışmamız şekillendirilmiştir. Gereç ve Yöntem: Çalışmamız retrospektif, Türkiye’den beş merkezin katıldığı, 2015-2020 yılları arasında tıbbi onkoloji polikliniğine başvuran hastaların dahil edildiği bir çalışmadır. Karsinoembriyonik antijen serum seviyelerinin kestirim (cut-off) değeri belirlendi. Hastalar serum CEA düzeyi kestirim değerinin altında ve üstünde olmak üzere iki gruba ayrıldı. Bu gruplarda sisplatin temelli kemoterapiler ile sisplatin temelli olmayan kemoterapilerin genel sağ kalım üzerine etkisi karşılaştırıldı. Bulgular: CEA kestirim değerinin altındaki hastalarda (n=166) sisplatin temelli kemoterapi alan olguların (n=94) genel sağ kalımı medyan 11,8 ay, sisplatin temelli olmayan kemoterapi alan olguların (n=72) 8,1 ay olarak hesaplandı (p=0,037). CEA kestirim değerinin üzerindeki hastalarda (n=140) sisplatin temelli kemoterapi alan olguların (n=85) medyan genel sağ kalımı 10,4 ay, sisplatin temelli olmayan kemoterapi alan hastalarda (n=55) 10,6 ay olarak hesaplandı (p=0,36). Sonuç: Çalışmamızda serum CEA düzeyi kestirim değerinin altında saptanan olgularda, birinci basamak tedavide sisplatin temelli kemoterapi alan hastaların genel sağ kalımı, sisplatin temelli olmayan kemoterapi alan hastaların genel sağ kalımına göre istatistiki olarak anlamlı şekilde daha uzun bulunmuştur. Bu sonuca göre CEA tedavi tercihini etkileyen prediktif bir tümör markeri olarak değerlendirilebilir. CEA düzeyi düşük olan hasta popülasyonunda sisplatin temelli tedavilerin tercih edilmesi daha uygun olabilir.

Is carcinoembryonic antigen (cea) predictive in metastatic gastric cancer?

Aim: Background: Gastric cancer ranks fifth in cancer incidence and fourth in cancer-related deaths worldwide. Carcinoembryonic antigen (CEA) is a tumor marker that has been used for a long time in the diagnosis and follow-up of gastric cancer. We designed our study to investigate the predictive aspect of this marker, whose prognostic aspect has been studied extensively before. Materials and Methods: Our study is a retrospective study in which five centers from Turkey participated. Patients who applied to the medical oncology outpatient clinic with the diagnosis of gastric cancer between 2015 and 2020 were included in the study. The cut-off value of CEA serum levels was found and the patients were divided into two groups. The effect of cisplatin-based chemotherapy on overall survival in these two groups was investigated. Results: In patients whose serum CEA level below the cut-off value (n=166), median overall survival of patients who received cisplatin-based chemotherapy (n=94) was calculated as 11.8 months, and 8.1 months in patients who received non-cisplatin-based chemotherapy (n=72) (p=0.037). In patients whose serum CEA level above the cut-off value (n=140) median overall survival of patients who received cisplatin-based chemotherapy (n=85) was calculated as 10.4 months, and 10.6 months in patients who received non-cisplatin-based chemotherapy (n=55) (p=0.36). Conclusion: In cases with CEA levels below the cut-off value, the overall survival of patients who received cisplatin-based chemotherapy in first-line therapy was found to be statistically significantly longer than patients who received non-cisplatin-based chemotherapy. CEA level can be a predictive tumor marker that affects treatment choice beyond being just prognostic. For this reason, it may be more appropriate to prefer cisplatin-based treatments in the patient population with low CEA levels.

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