大肠癌患者血清CEA和CA199表达与临床病理因素相关性的回顾性分析

Clinical characteristic of left and right colorectal cancer and its correlation with expression of CEA and CA199

目的:分析Ⅱ期大肠癌(CRC)肿瘤部位与肿瘤标志CEA和CA199表达差异,探讨大肠癌临床病理及分子生物学因素与预后的相关性。方法:对近10年中山大学附属肿瘤医院217例临床Ⅱ期左右侧CRC术后患者进行回顾性分析。结果:左大肠癌89例(41.0%),右大肠癌128例(59.0%)。经χ2检验,左右侧大肠癌肿瘤标志CEA水平差异有统计学意义,P=0.029;年龄差异也有统计学意义,P=0.005。生存亚组分析结果显示,右侧大肠癌CA199阳性患者生存率低于阴性,P=0.160,而左侧则无统计学意义,P=0.256。独立预后因素为肿瘤部位、肿瘤大体和术后复发转移(HR分别为1.97、0.47和6.74)。结论:CEA、肿瘤部位、肿瘤大体和术后复发转移是独立预后因素;右侧大肠癌患者血清CA199阳性与预后差相关。

OBJECTIVE： To analyze the tumor marker CEA,CA199 expression in stage Ⅱ colorectal cancer（CRC） and to discuss the correlationship between the prognosis of CRC and its clinical pathology and molecular biological factors. METHODS： The clinical data of 217 patients during the past ten years in the affiliated oncology hospital of Sun Yat-sen University were analyzed retrospectively. RESULTS： The left colorectal cancer were 89 cases （41.0 %） and the right were 128 cases （59.0%）. Between the left and right cases CEA and age had significantly differences （P=0. 029; P=0. 005）. Subgroup Kaplan-Meier analyze of CA199 in the right location shown that the patients with a high level had a shorter OS than those with low. The independent prognostic factors were tumor location, tumor morphology, recurrence and metas- tasis （HR respectively were 1.97, 0.47 and 6.74）. CONCLUSIONS： CEA is a prognostic factor on location, volume and relapse and metastsis between left and right colorectal cancer. In the right location the patients with a high level of CA199 have a shorter OS. Tumor site is an independent prognostic factor and it can be used as a reference of clinical medicine and treatment.