大肠癌术后检测腹腔引流液癌胚抗原的临床价值

Clinical value of measurement of carcinoembryonic antigen in abdominal drainage fluid after surgery for colorectal cancer

目的:探讨大肠癌术后检测腹腔引流液癌胚抗原(CEA)的临床意义。方法:检测112例大肠癌患者术前与术后第1天血清CEA浓度,以及术后第1天腹腔引流液中CEA浓度,并以35例肠道良性疾病患者术后腹腔引流液CEA浓度为对照,比较大肠癌患者手术前后血清CEA浓度的变化,以及大肠癌患者与肠道良性疾病患者术后腹腔引流液CEA浓度的差异,并分析大肠癌患者腹腔引流液CEA浓度与临床病理特征的关系。结果:大肠癌患者术后第1天血清CEA浓度较术前明显下降,术后第1天腹腔引流液CEA浓度明显高于肠道良性疾病者(均P<0.05)。大肠癌患者腹腔引流液CEA浓度与肿瘤分化程度无关(P>0.05),而与肿瘤浸润深度、临床分期呈同向变化关系,且有淋巴结或远处转移者明显高于无转移者(均P<0.05)。结论:大肠癌术后检测腹腔引流液CEA浓度对判断预后具有重要参考价值。

Objective： To investigate the clinical significance of the measurement of carcinoembryonic antigen （CEA） in abdominal drainage fluid after surgery for colorectal cancer Methods： q-he CEA concentration in the serum before surgery and on postoperative day （POD） 1, as well as the CEA concentration on POD 1 in abdominal drainage and the CEA concentration on POD 1 in abdominal fluid from 112 colorectal cancer patients were determined, drainage fluid from 35 patients with benign intestinal disease was used for comparison, q-he change of serum CEA level before and after surgery in colorectal cancer patients, and the difference in postoperative CEA concentration in abdominal drainage fluid between patients with colorectal cancer and benign intestinal disease were determined, and the relations of the CEA concentration in abdominal drainage fluid with clinicopathologic features in colorectal cancer patients were also analyzed. Results： In the group of colorectal cancer patients, the serum CEA concentration on POD 1 was significantly decreasedcompared with its level before surgery, and the CEA concentration on POD 1 in abdominal drainage fluid was significantly higher than that in group of patients with benign intestinal disease （both P〈0.05）. The CEA concentration in abdominal drainage fluid was not associated with the degree of tumor differentiation in colorectal patients （P〉0.05）, but changed in the same direction as the depth of invasion and clinical stage of the tumor, and was significantly higher in group of patients with lymph node or distant metastases than that in non-metastasis group （all P〈0.0$）. Conclusion： Measurement of the postoperative CEA concentration in abdominal drainage fluid has important predictive value for the outcome of colorectal cancer.