血清CEA、CA19-9、β_(2)-MG表达与膀胱癌患者吡柔比星膀胱灌注化疗疗效和生存期相关分析

Expression of serum CEA,CA19-9,andβ_(2)-MG predicts the therapeutic effect and survival of patients with bladder cancer undergoing intravesical chemotherapy with pirarubicin

目的探讨膀胱癌患者血清癌胚抗原(CEA)、癌抗原199(CA19-9)、β_(2)微球蛋白(β_(2)-MG)水平与膀胱癌患者吡柔比星膀胱灌注化疗疗效和生存期的关系。方法选取2021年3月~2023年4月在南阳市第一人民医院接受吡柔比星膀胱灌注化疗的98例膀胱癌患者作为研究对象,根据化疗结果分为化疗有效组(52例)和化疗无效组(46例)。比较两组患者的临床资料和血清CEA、CA19-9、β_(2)-MG水平,并进行单因素和多因素分析、生存分析及Cox回归分析。结果化疗有效组血清CEA、CA19-9、β_(2)-MG水平均低于化疗无效组(P<0.001)。进一步经多因素Logistic回归分析显示血清CEA水平是影响化疗效果和生存期的独立危险因素,高表达者化疗效果差,预后不良。血清CA19-9、β_(2)-MG水平也与化疗效果相关,但不是独立影响因素。结论血清CEA水平是预测膀胱灌注化疗疗效和生存期的重要指标,建议对膀胱癌患者进行血清CEA、CA19-9、β_(2)-MG检测,以指导个体化治疗方案的制定。

Objective To explore the relationship between the levels of serum carcinoembryonic antigen(CEA),cancer antigen 199(CA19-9),andβ_(2)-microglobulin(β_(2)-MG)in patients with bladder cancer and the therapeutic effect and survival of pirarubicin intravesical chemotherapy for bladder cancer.Methods A total of 98 patients with bladder cancer who received pirarubicin intravesical chemotherapy at Nanyang First People's Hospital from March 2021 to April 2023 were selected as the study subjects.They were divided into an effective chemotherapy group(52 cases)and an ineffective chemotherapy group(46 cases)based on the chemotherapy outcomes.The clinical data and serum levels of CEA,CA19-9,andβ_(2)-MG were compared between the two groups.Univariate and multivariate analysis,survival analysis,and Cox regression analysis were performed.Results The levels of serum CEA,CA19-9,andβ_(2)-MG in the effective chemotherapy group were lower than those in the ineffective chemotherapy group(P<0.001).Further multivariate logistic regression analysis showed that serum CEA level was an independent risk factor for chemotherapy effectiveness and survival.Patients with high CEA expression had poor chemotherapy outcomes and prognosis.Serum CA19-9 andβ_(2)-MG levels were also associated with chemotherapy outcomes but were not independent influencing factors.Conclusion Serum CEA level is an important indicator for predicting the therapeutic effect and survival of intravesical chemotherapy for bladder cancer.It is recommended to detect serum CEA,CA19-9,andβ_(2)-MG levels in patients with bladder cancer to guide the formulation of individualized treatment plans.