Relação dos níveis séricos do CEA com o acometimento linfonodal regional no pré-operatório do câncer gástrico

Objetivo: analisar a relacao entre os niveis sericos do antigeno carcino-embrionario CEA e o acometimento linfonodal regional no pre-operatorio do câncer gastrico. Metodo: realizado estudo transversal de prevalencia de 30 (trinta) doentes com diagnostico histopatologico de adenocarcinoma gastrico, nos quais o estadiamento clinico nao evidenciou doenca disseminada ou irressecavel. Com esses dados procedeu-se a coleta de amostras de sangue para dosagem do CEA; a seguir, os pacientes foram submetidos a laparotomia com estadiamento intra-operatorio. Caso nao houvesse sinais de irressecabilidade ou metastase, procedia-se a resseccao radical pretensamente curativa que consistia de gastrectomia subtotal ou total, omentectomia maior e menor e linfadenectomia a D2. Procedeu-se o exame microscopico de todos os linfonodos ressecados os quais foram, previamente, corados com hematoxilina-eosina. Resultado: CEA alterado no pre-operatorio em 06 (seis) pacientes (20%). Observou-se metastase, em um ou mais linfonodos em 17 doentes (56,66%). Conclusao: nao houve correlacao significante entre niveis sericos pre-operatorios do CEA com acometimento linfonodal regional em pacientes com câncer gastrico submetidos a resseccao gastrica com intencao curativa (p>0,05). Objective: study a possible relation between serum levels of CEA and the lymph-node acess of the patient who have gastric adenocarcinoma. Method: transversalis analysis of 30 (thirty) patients carriers of gastric adenocarcinoma whose clinical and surgical stages have not showed disseminated or non-ressectable disease. With this data, blood samples were colIected in order to peiform the tumor markers dosage previously mentioned. Then, they were submitted to laparotomy with intraoperatory staging. Whether there were no sings of irressecabilty or metastases, a pretentiously curative gastrectomy, which could be total or subtotal, with major and minor omentectomy and D2 lyphadenectomy was performed. AlI lymph-nodes ressected from patients were submitted to hystopathological exam with hematoxilin-eosin preparation. Results and conclusions: CEA levels were above normal in six patients (20%). However, there were metastases in on or more lymph-nodes resected from seventeel patients (56,66%). In order to perform a statistical study of a possible relation between these markers serum levels and lymph-node metastases, Binominal, Kolmogorov-Smimov and Fisher tests were used, according to the studied variables. FinalIy, there was no significant correlation between pre-operatory serum levels of the studied markers and regional lymphnodal metastases in gastric cancer patients submitted to gastric ressection with curative intention (p>0,05).