血清CEA、CA19-9及CA72-4联合检测预测转移性直肠癌患者化疗后预后的价值分析

The prognostic value analysis of the serum CEA,CA19-9 and CA72-4 to the patients with metastatic rectal cancer after chemotherapy

目的研究血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)及糖类抗原72-4(CA72-4)联合检测对转移性直肠癌患者化疗后预后的预测价值。方法回顾性纳入70例转移性直肠癌患者作为研究对象,均接受6周期西妥昔单抗联合伊立替康化疗方案,化疗结束后随访记录3年无进展生存率。比较不同预后患者化疗结束时CEA、CA19-9及CA72-4水平,分析CEA、CA19-9及CA72-4联合检测对预测患者预后的临床价值。结果随访7至36月,失访2例,化疗后3年无进展生存31例。以无进展生存为预后良好组,以疾病进展为预后不良组,两组CEA、CA19-9及CA72-4水平差异显著(P<0.05)。ROC分析结果显示CEA、CA19-9及CA72-4判断预后的AUC为0.651,0.693,0.661,敏感度为0.622,0.568,0.703,特异度为0.677,0.774,0.581。联合检测结果与随访结果一致性满意(Kappa=0.762,P=0.000),联合检测判断预后的AUC为0.879,敏感度为0.819,特异度为0.839。结论 CEA、CA19-9及CA72-4联合检测对判断转移性直肠癌患者化疗后预后具有较高的准确性。

Objective To study the prognostic value analysis of the serum CEA,CA19-9 and CA72-4 to the patients with metastatic rectal cancer after chemotherapy. Methods 70 patients with metastatic rectal cancer were included in the study and received 6 cycles of cetuximab combined with erinotecan chemotherapy,the 3 years progression free survival after chemotherapy were recorded. The CEA,CA19-9 and CA72-4 levels at the end of chemotherapy in patients with different prognosis were compared. The clinical value of combined detection of CEA,CA19-9 and CA72-4 in predicting the prognosis of patients were analyzed. Results The time of followed up were 7 to 36 months,2 cases were lost and 31 had no progress in 3 years after chemotherapy. The progression free survival was a good prognosis group. The patients with disease progressed were the poor prognosis group. There were significant differences in the levels of CEA,CA19-9 and CA72-4 in the two groups（ P〈0. 05）. The results of ROC analysis showed that the AUC of judging the prognosis of CEA,CA19-9 and CA72-4 were 0. 651,0. 693,0. 661.The sensitivity were 0. 622,0. 568,0. 703. The specificity were 0. 677,0. 774,0. 581. The conformance of test results and the follow-up results was satisfactory（ Kappa = 0. 762,P = 0. 000）. The AUC of combined test to prognosis was 0. 879,the sensitivity was 0. 819 and the specificity was 0. 839. Conclusion The combined detection of CEA,CA19-9 and CA72-4 has a high accuracy in judging the prognosis of patients with metastatic rectal cancer after chemotherapy.