术前血清癌胚抗原水平与结肠癌临床病理特征及其预后关系的分析

Analysis of the Relationship between Serum Carcinoembryonic Antigen Level and Clinicopathological Features and Prognosis of Colon Cancer

目的探讨术前血清癌胚抗原水平与结肠癌临床病理特征及其预后的关系。方法选择手术治疗的结肠癌患者106例,根据术前血清CEA水平分为CEA正常组、CEA升高组和CEA显著升高组,比较各组的临床病理特征、术后远处转移、5年生存率,并采用Cox回归分析影响预后的因素。结果术前血清CEA正常组38例(35.45%),CEA升高组47例(44.34%),CEA显著升高组21例(20.21%)。三组肿瘤直径、淋巴结转移、肿瘤分化程度和肿瘤TNM分期的差异均有统计学意义(P<0.05),三组肿瘤术后远处转移例数的差异有统计学意义(P<0.05)。CEA显著升高组、CEA升高组和CEA正常组的5年生存率分别为42.86%、53.19%与71.05%,差异有统计学意义(χ~2=5.95,P<0.05)。Cox回归显示,术前CEA水平、肿瘤分化程度、肿瘤TNM分期是影响结肠癌患者预后的独立危险因素。结论结肠癌患者术前血清CEA升高与患者的临床病理特征有密切关系,对于判断患者的预后具有重要意义。

Objective To investigate the relationship between preoperative serum carcinoembryonic antigen level and clinicopathological features and prognosis of colon cancer. Methods 106 patients with colorectal cancer were divided into CEA normal group, CEA higher group and CEA significantly higher group. The clinical and pathological features, postoperative distant metastasis,5-year survival rates were compared, cox regression analysis was used to analyze prognostic factors. Results There were 38 cases （ 35.45% ） in CEA normal group ,47 cases （44.34%） in CEA higher group and 21 cases （20.21%） in CEA sig- nificantly higher group. Tumor diameter,lymph node metastasis,tumor differentiation and tumor TNM staging among the 3 groups had statistically significant difference （ P 〈 0.05 ）. There were significant differences in the number of distant metastasis among the 3 groups （P 〈 0.05 ）. The 5-year survival rates of the CEA significantly higher group, CEA higher group and CEA normal group were 42.86% ,53.19% and 71.05% , respectively. The difference was statistically significant （χ^2 = 5.95, P 〈 0.05 ）. Cox regression showed that preoperative CEA levels, tumor differentiation, and tumor TNM staging were independent risk factors for prognosis in patients with colon cancer. Conclusion Preoperative serum CEA elevation in colon cancer patients are closely relat- ed with the clinical and pathological characteristics, it has significance in the prognosis of patients.