术前血清癌胚抗原水平与结肠癌临床病理特征在手术预后的影响

The effects of preoperative serum carcinoembryonic antigen level and clinicopathological features of colon cancer on the prognosis of operation

目的:探讨术前血清癌胚抗原水平与结肠癌临床病理特征在手术预后中的关系。方法:选择于2015年1月-2017年6月在结直肠肿瘤外科行结肠癌择期根治性手术治疗的患者53例。根据术前CEA水平分为CEA显著升高组、CEA升高组、CEA正常组,比较三组的临床病理特征、术后远处转移,了解手术后的预后情况。入院后抽取清晨空腹静脉血,采用瑞士罗氏公司E-170电化学发光分析仪及其配套试剂检测CEA,观察并比较术前血清CEA不同分组患者的病理特征、术后肿瘤远处转移情况。结果:53例结肠癌患者中,术前血清CEA正常组、CEA升高组、CEA显著升高组性别、年龄差异均无统计学意义(P>0.05)。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),与CEA正常组及CEA升高组相比,CEA显著升高组的出现淋巴结转移、肿瘤直径>5cm、肿瘤呈低分化程度、TNM分期为Ⅳ期的例数均明显增多。三组出现肿瘤远处转移、肝转移、肺转移及其他部位转移例数差异均有统计学意义(P<0.05),与CEA正常组及CEA升高组相比,CEA显著升高组出现肿瘤转移例数均明显增多。结论:结肠癌患者术前血清CEA升高对判断患者的手术预后具有重要意义,与患者的临床病理特征有密切关系。

Objective： To explore the effect of preoperative serum carcinoembryonic antigen level and clinicopathological features of colon cancer on the prognosis of operation. Methods： 53 patients with colon cancer underwent elective radical surgery in colorectal cancer surgery department of our hospital from January 2015 to June 2017 were selected. According to the preoperative level of CEA, the patients were divided into three groups： the significantly increased CEA group, the increased CEA group and the normal group. The clinicopathological features, distant metastasis and prognosis after operation were compared among three groups. After admission, fasting venous blood was collected in the early morning. CEA were detected by E-170 electroluminescence analyzer of Roche and its matching reagent. The pathological characteristics in different groups of serum CEA before operation and distant metastasis of tumor were observed and compared before and after operation. Results： Among 53 patients with colon cancer, the difference of gender and age in three groups was no statistically significant（P〉0.05）. There were statistically significant difference of tumor diameter, lymph node metastasis, tumor differentiation and TNM staging among three groups（P〈0.05）. Compared with the increased CEA group and the normal group, tumor diameter, lymph node metastasis, lymph node metastasis, tumor diameter〉5 cm and TNM stage Ⅳ increased significantly in the significantly increased CEA group. The difference of distant metastasis, liver metastasis, lung metastasis and other metastases in three groups was statistically significant（P〈0.05）. Compared with the group with increased CEA and the normal group, the group with significantly increased CEA had more cases of tumor metastasis. Conclusion： The elevation of serum CEA in patients with colon cancer before operation was of great significance in judging the prognosis of the patients and was closely related to the clinicopathological features of the patients.