title: Prognostic significance of preoperative and postoperative CK19 and CEA mRNA levels in peripheral blood of patients with gastric cardia cancer.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Qiao
authors.affiliation: 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.
authors.forename: Chuan-Gui
authors.initials: CG
authors.lastname: Chen
authors.affiliation: 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.
authors.forename: Jie
authors.initials: J
authors.lastname: Yue
authors.affiliation: 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.
authors.forename: Ming-Quan
authors.initials: MQ
authors.lastname: Ma
authors.affiliation: 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.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Ma
authors.affiliation: 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.
authors.forename: Zhen-Tao
authors.initials: ZT
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002299:Cardia / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053208:Kaplan-Meier Estimate; D053539:Keratin-19 / Q000097:blood*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012333:RNA, Messenger / Q000378:metabolism; D012372:ROC Curve; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D012333:RNA, Messenger
keywords: Carcinoembryonic antigen; Clinicopathological factor; Cytokeratin 19; Gastric cardia cancer; Prognosis