直肠癌新辅助化疗前后血清肿瘤异常蛋白和癌胚抗原水平变化

Alteration of Serum Tumor Abnormal Protein and Carcinoembryonic Antigen in Patients with Rectal Cancer before and after Neoadjuvant Chemotherapy

目的:探讨直肠癌患者新辅助化疗前后血清肿瘤异常蛋白(TAP)、癌胚抗原(CEA)水平变化及其与化疗疗效的关系。方法:回顾性分析收治的新辅助化疗直肠癌患者100例,同期选取健康人员100例,采用放射免疫法检测血清CEA水平及采用计算机TAP检测系统检测血清TAP水平,采用ROC曲线分析TAP、CEA水平与化疗疗效的关系。结果:直肠癌患者血清TAP、CEA水平分别是(175.21±25.42)μm^2、(35.65±4.23)ng/mL,明显高于健康人员[分别是(75.45±9.98)μm^2、(1.26±0.34)ng/mL,P<0.05];直肠癌患者新辅助化疗后,完全缓解(CR)20例(20.0%)、部分缓解(PR)66例(66.0%)、稳定(SD)10例(10.0%)、进展(PD)4例(4.0%);在TAP、CEA水平及下降百分比方面,CR和PR患者化疗后较化疗前显著下降,PD患者化疗后较化疗前均明显上升(P<0.05),SD患者化疗后较化疗前下降(P<0.05);ROC曲线分析结果显示,在评估直肠癌新辅助化疗有效性的敏感度、特异度、准确度、ROC方面,TAP以>18%为临界值时为93.0%,71.4%,90.0%,0.712,CEA以>27%为临界值时91.9%,71.4%,89.0%,0.734,二者联合时为98.8%,92.9%,98.0%,0.904,二者联合时明显高于二者单独时(P<0.05)。结论:直肠癌患者血清TAP、CEA水平升高,检测其水平变化可作为评估其新辅助化疗疗效的重要指标,且二者联合检测时具有更佳的评估效能。

Objective To discuss the alteration of serum tumor abnormal protein(TAP)and carcinoembryonic antigen(CEA)in patients with rectal cancer before and after neoadjuvant chemotherapy and their relationship with chemotherapy efficacy.Methods One hundred patients with neoadjuvant chemotherapy for rectal cancer were retrospectively reviewed,100healthy persons were selected in the same period.The serum CEA level was detected by radioimmunoassay,the serum TAP level was detected by TAP detection computer system,and the relationship between TAP and CEA levels and chemotherapy efficacy was analyzed by ROC curve.Results Serum TAP and CEA levels in patients with rectal cancer were(175.21±25.42)μm^2and(35.65±4.23)ng/mL,which was significantly higher than that of healthy people[(75.45±9.98)μm^2and(1.26±0.34)ng/mL](P<0.05).After neoadjuvant chemotherapy for patients with rectal cancer,complete remission(CR)was performed in20patients(20.0%),partial remission(PR)in66patients(66.0%),stable(SD)in10patients(10.0%),and progression(PD)in4patients(4.0%).In terms of TAP and CEA levels and percentage of decline,CR and PR patients were decreased significantly after chemotherapy compared with those before chemotherapy(P<0.05),PD patients were increased significantly after chemotherapy compared with those before chemotherapy(P<0.05).SD patients were decreased after chemotherapy compared with those before chemotherapy(P<0.05).The results of ROC curve analysis showed that in assessing the sensitivity,specificity,accuracy,and area under curve of neoadjuvant chemotherapy for rectal cancer,the percentage of TAP decline was93.0%,71.4%,90.0%and0.712when the threshold was>18%,the percentage of CEA decline was91.9%,71.4%,89.0%and0.734when the threshold was>27%.When they were combined,they were98.8%,92.9%,98.0%and0.904respectively,and when the two parameters were combined,they were significantly higher than those when they were used alone(P<0.05).Conclusion The serum TAP and CEA levels in patients with rectal cancer are increased,and the detection of the level changes can be used as the important indicator to evaluate the efficacy of neoadjuvant chemotherapy,and the combination of the two parameters has the better evaluation efficiency.