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Abstract: Background. We explored the prognostic value of the up-regulated carbohydrate antigen (CA19-9) in node-negative patients with gastric cancer as a surrogate marker for micrometastases. Patients and methods. Micrometastases were determined using reverse transcription quantitative polymerase chain reaction (RT-qPCR) for a subgroup of 30 node-negative patients. This group was used to determine the cut-off for preoperative CA19-9 serum levels as a surrogate marker for micrometastases. Then 187 node-negative T1 to T4 patients were selected to validate the predictive value of this CA19-9 threshold. Results. Patients with micrometastases had significantly higher preoperative CA19-9 serum levels compared to patients without micrometastases (p = 0.046). CA19-9 serum levels were significantly correlated with tumour site, tumour diameter, and perineural invasion. Although not reaching significance, subgroup analysis showed better five-year survival rates for patients with CA19-9 serum levels below the threshold, compared to patients with CA19-9 serum levels above the cut-off. The cumulative survival for T2 to T4 node-negative patients was significantly better with CA19-9 serum levels below the cut-off (p = 0.04). Conclusions. Preoperative CA19-9 serum levels can be used to predict higher risk for haematogenous spread and micrometastases in node-negative patients. However, CA19-9 serum levels lack the necessary sensitivity and specificity to reliably predict micrometastases.
Keywords: gastric cancer, micrometastases, CA19-9, rak (medicina), želodec, metastaze, diagnostika, antigeni, tumorski označevalci
Published in DiRROS: 09.05.2024; Views: 61; Downloads: 45
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Abstract: DNA vakcine predstavljajo obetaven pristop imunoterapije raka, predvsem zaradi njihove enostavnosti, stabilnosti in varnosti. DNA vakcine temeljijo na vnosu plazmidne DNA z zapisom za enega ali več tumorskih antigenov, udeleženih v nastanku, napredovanju ali zasevanju rakavih celic. Z vnosom DNA vakcine spodbudimo imunski odziv usmerjen proti tumorskemu antigenu, kar potencialno vodi do uničenja rakavih celic. Kljub številnim prednostim DNA vakcin pred klasičnimi vakcinami njihovo uporabo v humani kliniki omejuje prešibak antigen-specifični imunski odziv. Za izboljšanje imunogenosti DNA vakcin se razvoj osredotoča na optimizacijo sestave plazmidne DNA, raziskovanje novih tumorskih antigenov, razvoj novih dostavnih sistemov in sočasna uporaba adjuvantnih in imunomodulatornih molekul. Tovrstni pristopi so del številnih kliničnih raziskav na področju imunoterapije raka in predstavljajo korak bližje k izboljšanju imunogenosti DNA vakcin, učinkovitejšemu uničenju rakavih celic in lažjemu prenosu DNA vakcinacije v humano klinično prakso.
Keywords: DNK vakcine, dostavni sistemi, tumorski antigeni, imunogenost
Published in DiRROS: 26.06.2019; Views: 2536; Downloads: 684
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