术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用

Combined application of preoperative serum CEA, CA19-9 and CA50 levels in liver metastasis of colorectal cancer

目的研究术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用价值。方法选择2015年1月至2017年1月在中国医学科学院肿瘤医院接受手术治疗的结直肠癌患者316例为研究对象,其中结直肠癌伴有肝转移的患者158例作为实验组,并按照性别、年龄等匹配结直肠癌不伴有肝转移的患者158例作为对照组。对所有患者的术前血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)以及糖类抗原50(CA50)进行检测,采用单因素及多因素分析以上肿瘤标志物单独或联合检测在结直肠癌肝转移中的预测价值。结果单因素及多因素分析结果表明,术前血清CEA、CA19-9、CA50升高与结直肠癌发生肝转移显著相关(P <0.05),CEA、CA19-9、CA50单独预测结直肠癌肝转移的敏感度分别为62.7%、57.4%、67.1%;特异度分别为58.2%、53.5%、56.6%。CEA、CA19-9、CA50联合诊断预测直肠癌肝转移的敏感度和特异度分别为74.3%、76.3%。结论术前血清CEA、CA19-9、CA50升高是结直肠癌肝转移的独立预测因素,但三者单独预测结直肠癌肝转移的敏感度和特异度均较低。三者联合检测对于预测结直肠癌肝转移的敏感度和特异度均较高,可以作为结直肠癌肝转移的预测模型。

Objective To study the application value of preoperative serum CEA, CA19-9 and CA50 in the prediction of liver metastasis of colorectal cancer. Methods A total of 316 patients with colorectal cancer who underwent surgery at the Cancer Hospital of Chinese Academy of Medical Sciences from January 2015 to January 2017 were enrolled in this study. Among them, 158 patients with colorectal cancer and liver metastases were included in the observation group. Other 158 case-matched patients with colorectal cancer without liver metastases were included in the control group. Preoperative serum carcinoembryonic antigen （CEA）, carbohydrate antigen 19-9 （CA19-9）, and carbohydrate antigen 50 （CA50） were measured in all patients. The univariate and multivariate analysis of the above tumor markers were used alone or in combination in this study. Results The results of uinvariate and multivariate analysis showed that increased preoperative serum CEA, CA19-9 and CA50 significantly correlated with liver metastases in patients with colorectal cancer （P 〈 0.05）. The sensitivity of CEA, CA19-9 and CA50 in predicting colorectal cancer liver metastasis was 62.7%, 57.4% and 67.1%, respectively; the specificities were 58.2%,53.5%, 56.6%, respectively. The sensitivity and specificity of combined diagnosis of CEA, CA19-9, and CA50 for liver metastasis in colorectal cancer were 74.3% and 76.3%, respectively. Conclusions The preoperative serum CEA, CA19-9 and CA50 were independent predictors of liver metastasis in patients with colorectal cancer. But these three tumor markers predicted liver metastasis with low sensitivity and specificity. The combined application of these three tumor markers had higher sensitivity and specificity in predicting liver metastasis for patients with colorectal cancer and could be used as a predictive model for liver metastasis of colorectal cancer.