肿瘤标志物、临床病理因素与结直肠癌淋巴结转移的关系

Correlations of lymphatic metastasis with clinicopathological factors and tumor markers in colorectal cancer

目的探讨结直肠癌(CRC)淋巴结转移与临床病理类型和肿瘤标志物等因素的关系,研究其高危因素。方法选取2012~2014年于广西医科大学第一附属医院结直肠肛门外科499例行手术治疗的CRC患者完整的临床资料,对其进行回顾性研究分析,对数据进行单因素分析,有差异的因素进入多因素Logistic回归分析。结果患者性别、年龄、肿瘤部位、大体类型浸润及术前CA153表达水平与淋巴结转移无相关(P>0.05)。术前CEA、CA724、CA199、CA242及CA125的表达与淋巴结转移呈正相关(P<0.05)。浸润深度、癌周脉管癌栓、组织学类型及CA242是影响淋巴结转移的独立危险因素(P<0.05)。结论术前检查肿瘤标志物CEA、CA724、CA199及CA125对判断CRC淋巴结转移有一定的参考价值。

Objective To explore the correlations of lymph node metastasis with clinicopathological factors and tumor markers（TM） in colorectal cancer, and to look for the risk factors for lymphatic metastasis. Methods The complete clinicopathological data and TM data of 499 patients with colorectal cancer who underwent radical resection in the First Affiliated Hospital of Guangxi Medical University from 2012 to 2014 were retrospectively analyzed. The correlations of lymphatic metastasis with clinicopathological factors and TM were evaluated by single-factor analysis and multivariate logistic regression analysis. Results The results of single-factor analysis indicated that there was no significant correlation between lymphatic metastasis and patients＇ age, gender, tumor location, tumor type, perineural invasiveness, or preoperative CA153 level（P〈0.05）. The preoperative levels of CEA, CA724, CA199, CA242 and CA125 were significantly correlated with lymph metastasis（P〈0.05）. Logistic regression analysis showed that the depth of invasion, carcinoma vascular tumor emboli, tumor histological types and CA242 were the independent risk factors for lymphatic metastasis（P〈0.05）. Conclusions The depth of cancer invasion, carcinoma vascular tumor emboli, tumor histological types and CA242 are the independent risk factors for lymph node metastasis. Preoperative detection of CEA, CA724, CA199 and CA125 has certain reference value in the diagnose of lymph node metastasis in colorectal cancer.