Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2017; 23(8): 1424-1433
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1424
Prognostic significance of preoperative and postoperative CK19 and CEA mRNA levels in peripheral blood of patients with gastric cardia cancer
Yu-Feng Qiao, Chuan-Gui Chen, Jie Yue, Ming-Quan Ma, Zhao Ma, Zhen-Tao Yu
Yu-Feng Qiao, Chuan-Gui Chen, Jie Yue, Ming-Quan Ma, Zhao Ma, Zhen-Tao Yu, Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin 300060, China
Author contributions: Qiao YF designed the study, analyzed the data, and wrote the paper; Chen CG and Yue J collected the data; Ma MQ and Ma Z performed the data analysis; Yu ZT designed the study and revised the paper; all authors have read and approved the final version to be published.
Supported by the National Key Clinical Specialist Construction Programs of China, No. 2013-544; Science and Technology Development Fund of Tianjin Education Commission for Higher Education, No. 20130121; Science Foundation of Tianjin Medical University, No. 2016KYZM03.
Institutional review board statement: This study was reviewed and approved by the Research Ethics Committee of Tianjin Medical University Cancer Institute and Hospital Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zhen-Tao Yu, MD, PhD, Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Huanhuxi Road, Tiyuanbei, HeXi District, Tianjin 300060, China. qyf800117@sina.com
Telephone: +86-22-23340123 Fax: +86-22-23359984
Received: October 26, 2016
Peer-review started: October 27, 2016
First decision: December 1, 2016
Revised: December 16, 2016
Accepted: January 4, 2017
Article in press: January 4, 2017
Published online: February 28, 2017
Processing time: 123 Days and 4.6 Hours
Abstract
AIM

To evaluate the clinical and prognostic significance of preoperative and postoperative cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) mRNA levels in peripheral blood of patients with gastric cardia cancer (GCC).

METHODS

We detected the preoperative and postoperative mRNA levels of CK19 and CEA in peripheral blood of 129 GCC patients by using reverse transcription-polymerase chain reaction and evaluated their clinical and prognostic significance by univariate Kaplan-Meier survival analysis and multivariate Cox proportional hazard analysis. A new prognostic model which stratified patients into three different risk groups was established based on the independent prognostic factors.

RESULTS

Elevated preoperative and postoperative CK19 and CEA mRNA levels in peripheral blood of GCC patients were associated with lymph node metastasis. Univariate analysis showed that tumor size, histological grade, depth of tumor invasion, lymph node metastasis, preoperative CK19 mRNA, and preoperative and postoperative CEA mRNA levels were correlated with the prognosis of GCC patients. The multivariate analysis showed that lymph node status (P = 0.018), preoperative CK19 (P = 0.035) and CEA (P = 0.011) mRNA levels were independent prognostic factors for overall survival (OS). The 5-year OS rates for the low-, intermediate-, and high-risk groups were 48.3%, 22.6%, and 4.6%, respectively (P < 0.001).

CONCLUSION

Elevated preoperative CK19 and CEA mRNA levels may be regarded as promising biomarkers for predicting lymph node metastasis and poor prognosis in patients with GCC. This new prognostic model may help us identify the subpopulations of GCC patients with the highest risk.

Keywords: Gastric cardia cancer; Cytokeratin 19; Carcinoembryonic antigen; Clinicopathological factor; Prognosis

Core tip: This is a retrospective study that evaluated the clinical and prognostic significance of the preoperative (pre-) and postoperative (post-) mRNA levels of cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) in peripheral blood of patients with gastric cardia cancer. Increased pre- and post-CK19 and CEA mRNA levels were associated with positive lymph node metastasis. Elevated pre- but not post-CK19 and CEA mRNA levels were independent prognostic factors for overall survival (OS). A new prognostic model was established based on independent prognostic factors (lymph node status, pre-CK19 and pre-CEA mRNA levels), and there was a significant difference in OS among the three different risk groups.