术前血清CEA与CA199水平对结直肠黏液腺癌和印戒细胞癌患者预后的影响

Influence of preoperative serum CEA and CA199 for the prognosis of patients with colorectal mucinous adenocarcinoma and signet ring cell carcinoma

目的探讨术前血清癌胚抗原(CEA)和糖链抗原199(CA199)水平对结直肠黏液腺癌、印戒细胞癌患者预后的影响。方法回顾性分析2008年7月至2014年11月郑州大学第一附属医院收治的446例结直肠黏液腺癌、印戒细胞癌患者的临床资料,分析术前CEA、CA99水平与结直肠癌患者各临床病理因素以及生存预后的关系。结果术前血清CEA、CA199水平与患者的年龄、位置、TNM分期有相关性(P<0.05),与家族性肿瘤史、中性粒细胞数、合并症及神经脉管侵犯方面无相关性(P>0.05)。不同水平的CEA、CA199组黏液腺癌生存率比较,差异有统计学意义(P<0.05),印戒细胞癌患者差异无统计学意义(P>0.05)。多因素分析显示,右半结肠癌、TNM分期晚、印戒细胞癌、术前CA199水平升高是影响患者总体生存的独立危险因素。结论术前血清CEA和CA199可以作为结直肠黏液腺癌、印戒细胞癌患者预后判断的参考指标。

Objective To investigate the influence of preoperative serum carcino-embryonic antigen （CEA） and carbohydrate antigen199（CA199） for the prognosis of patients with colorectal mucinous adenocarcinoma and signet ring cell carcinoma. Methods Clinicopathological data of 446 cases of colorectal mucinous and signet ring cell carcinoma patients in the First Affiliated Hospital of Zhengzhou University from July 2008 to November 2014 were retrospectively analyzed. The relationship between the preoperative CEA and CA99 levels and the clinicopathological factors of colorectal cancer patients and the survival prognosis were analyzed. Results The levels of serum CEA and CA199 were correlated with the age, location and TNM stage of the patients（ P 〈0.05 ）, and these were not correlated with family history, neutrophil count, complication and neurovascular invasion（ P 〉0.05 ）. The survival rate of mucinous adenocarcinoma in different levels of CEA and CA199 group was statistically significant （ P 〈0.05 ）, while the difference between signet ring cell carcinoma patients was not statistically significant（ P 〉0.05 ）. In multivariate analysis, right colon cancer, TNM, signet ring cell carcinoma, preoperative CA199 level were independent risk factors for overall survival of patients. Conclusion Preoperative serum CEA and CA199 can be used as a reference index for predicting the prognosis of colorectal mucinous adenocarcinoma and signet ring cell carcinoma.