CEA在结直肠癌肿瘤的表达特征及其对微转移的预测价值

Expression of CEA in colorectal carcinoma and its value in predicting micrometastasis

目的研究癌胚抗原(CEA)在结直肠癌肿瘤的表达特征及其对微转移的预测价值。方法回顾性分析我院84例经手术治疗的结直肠癌患者的临床资料,另选同期移植供体结肠黏膜者50例为对照,取肿瘤组织、癌旁组织、正常组织分别进行HE染色、CEA免疫组织化学法检测,比较三种类型组织CEA阳性表达率,另观察CEA表达与年龄、性别、肿瘤大小、肿瘤部位、分化程度、Dukes分期、浸润深度、淋巴结转移、2年复发的相关性,并分析CEA预测淋巴结微转移的准确性,以Spearman等级相关分析法观察两者相关性。结果 84例结肠癌组织CEA阳性表达90.5%,高于癌旁组织60.7%表达及正常组织无阳性表达(P<0.01)。不同年龄、性别、肿瘤大小、肿瘤部位、分化程度结直肠癌患者CEA阳性表达无显著差异(P>0.05)。Dukes分期、浸润深度、淋巴结转移、2年复发与CEA表达存在明显相关性(P<0.05)。32例有淋巴结微转移的患者CEA呈阳性31例,仅1例阴性表达,差异无统计学意义(P>0.05,r=0.821)。结论 CEA在结直肠癌组织、癌旁组织及正常结肠组织内表达存在显著差异,其表达与Dukes分期、浸润深度、淋巴结转移、2年复发有相关性,而CEA预测淋巴结微转移的准确度高,其阳性表达与淋巴结微转移有较强相关性。

Objective To study the expression of carcino-embryonic antigen（CEA） in colorectal carcinoma and its value in predicting micrometastasis.Methods The clinical data of 84 patients with colorectal carcinoma treated by surgery were analyzed retrospectively. Another 50 patients undergoing transplantation of coenosarc colonic mucosa were selected as control.Tumor tissues, para-carcinoma tissues and normal tissues were detected by HE staining and CEA immunohistochemical staining respectively. The positive expression rates of CEA in three types of tissues were compared. The correlation between expression of CEA and age, gender, tumor size, tumor location, differentiation degree, Dukes stage, invasion depth, lymph node metastasis and 2-year recurrence was observed. The accuracy of CEA in predicting lymph node metastasis was analyzed, and the correlation was observed by Spearman rank correlation analysis. Results The positive expression of CEA in colon cancer tissues（90.5%）was significantly higher than para-carcinoma tissues（60.7%） and normal tissues（P〈0.01）; there were no significant differences in positive expression of CEA between patients with colorectal carcinoma of different age, gender, tumor size, tumor location and differentiation degree（P〉0.05）. And there was a significant correlation between Dukes stage, invasion depth, lymph node metastasis, 2-year recurrence and expression of CEA（P〈0.05）, in 32 cases with lymph node micrometastasis, CEA was positive in 31 cases, and only 1 case was negative expression（P〉0.05）, r =0.821.Conclusion Expression of CEA in colorectal carcinoma tissues, paracancerous tissues and normal colon tissues is significantly different.The expression is related to Dukes stage, invasion depth,lymph node metastasis and 2-year recurrence. The accuracy of CEA in predicting lymph node micrometastasis is high, the positive expression and lymph node micrometastasis are strongly correlated.