结直肠癌浸润转移与癌胚抗原的关系

Serum and tumor CEA and tumor invasion and metastasis in patients with colorectal cancer

目的研究结直肠癌浸润转移患者与癌胚抗原（ＣＥＡ）的关系．方法结直肠癌患者６０例，男３６例，女２４例；年龄２７岁～８０岁，平均５４９岁±１３２岁，皆经手术及病理证实．ＤｕｋｅｓＡ１６例，Ｂ２０例，Ｃ１４例，Ｄ１０例．用ＲＩＡ测定血清ＣＥＡ水平，并用免疫组织化学方法检测肿瘤组织ＣＥＡ的表达．结果血清ＣＥＡ水平及肿瘤组织ＣＥＡ表达均与肿瘤浸润及转移有关．有转移的患者血清ＣＥＡ水平（１１４６μｇ／Ｌ±７９１μｇ／Ｌ）明显高于无转移的患者（４５３μｇ／Ｌ±３２３μｇ／Ｌ，Ｐ＜００１），肿瘤组织ＣＥＡ表达强度在有转移与无转移患者中亦有明显差异（强阳性率８７５ｖｓ３８９％，Ｐ＜００１）．肿瘤组织ＣＥＡ表达类型也与肿瘤转移有关，呈胞浆型表达者发生淋巴结转移（５４１％）及远处转移（２７０％）明显高于呈顶端型表达者（１９０％，０％，Ｐ＜００１）．结论ＣＥＡ与结直肠癌浸润转移呈正相关。

AIM To study serum and tumor CEA and tumor invasion and metastasis in patients with colorectal cancer. METHODS Serum CEA levels were measured in 60 patients with surgically and pathologically proved colorectal cancer (males 36, females 24, mean age 54 9±13 2 years; Dukes A16, B29, C14 and D10) by RIA, and CEA expression in tumor tissues were also detected by immunohistochemical stainings. RESULTS The serum CEA level of patients with colorectal cancer and the CEA expression in tumor tissues were correlated with tumor invasion and metastasis. The serum CEA level of the patients with tumor metastasis was higher than that of the patients without metastasis (11 46μg/L±7 91μg/L vs 4 51μg/L±3 23μg/L, P <0 01). The intensity level of the CEA expression in tumor tissues of the patients with metastasis was higher than that of the patients without metastasis (87 5% vs 38 9%, P <0 01). There was a close correlation between the CEA staining patterns in tumor tissues and tumor metastasis. Carcinomas of cytoplasma pattern had a higher incidence of lymph node (54 1% vs 19%, P <0 01) and distant site (27% vs 0%, P <0 01) metastasis. CONCLUSION There is a positive correlation between CEA and tumor invasion and metastasis in the patients with colorectal cancer. The pattern of CEA staining in tumor tissues is a useful prognostic indicator.