结直肠癌患者血清CEA和CA19-9水平与肝转移的关系

Relationship of serum CEA and CA19-9 levels with liver metastasis in colorectal cancer patients

目的探讨结直肠癌(CRC)患者血清癌胚抗原(CEA)和糖类抗原19-9(CA19-9)水平与肝转移的关系。方法应用电化学发光免疫分析法检测127例CRC患者的血清CEA和CA19-9水平,分析CRC肝转移与血清CEA和CA19-9阳性率的关系,比较不同临床特征CRC患者的血清CEA和CA19-9阳性率,分析CEA和CA19-9阳性表达与CRC肝转移患者预后的关系。结果127例患者中,有肝转移71例,无肝转移56例;CEA阳性67例,CA19-9阳性53例。有肝转移CRC患者的血清CEA和CA19-9阳性率分别为60.6%(43/71)和57.7%(41/71),均高于无肝转移患者的42.9%(24/56)和21.4%(12/56),差异均有统计学意义(P﹤0.05)。CEA和CA19-9均为阳性的CRC患者的肝转移率(90.3%)高于其中一项阳性患者的肝转移率(70.7%),差异有统计学意义(P﹤0.05)。不同性别、年龄、肿瘤直径、肿瘤部位、乙肝情况的CRC患者的血清CEA和CA19-9阳性率比较,差异均无统计学意义(P﹥0.05);低分化和Ⅲ~Ⅳ期CRC患者的血清CEA和CA19-9阳性率均明显高于中高分化和Ⅰ~Ⅱ期患者,差异均有统计学意义(P﹤0.01)。CEA和CA19-9均为阳性的CRC肝转移患者的3年生存情况优于CEA或CA19-9一项阳性的CRC肝转移患者,差异有统计学意义(P﹤0.05)。结论血清CEA和CA19-9水平有助于判断CRC患者是否存在肝转移,联合检测血清CEA和CA19-9水平对预测CRC肝转移及预后具有重要意义。

Objective To investigate the relationship of serum carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9(CA19-9) levels with liver metastasis in colorectal cancer patients. Method One hundred and twenty-seven CRC patients were selected and levels of serum CEA and CA19-9 were detected by electrochemiluminescence immunoassay. The relationship between positive rates of serum CEA and CA19-9 and CRC liver metastasis was analyzed, and positive rates of serum CEA and CA19-9 in CRC patients with different clinical characteristics were compared, the relationship of positive expression of CEA and CA19-9 with prognosis of CRC patients with liver metastasis were analyzed. Re-sult There were 71 cases of liver metastasis and 56 cases of non liver metastasis in 127 patients, with 67 cases of positive CEA and 53 cases of positive CA19-9. The positive rates of CEA and CA19-9 in patients with liver metastasis were60.6%(43/71) and 57.7%(41/71), which were high than those of 42.9%(24/56) and 21.4%(12/56) in patients without liver metastasis, with statistically significant differences observed(P<0.05). Liver metastasis rate of CRC patients with positive CEA and CA19-9(90.3%) was significantly higher than that with only one positive expression(70.7%)(P<0.05).Comparison of positive rates of serum CEA and CA19-9 in CRC patients with different sex, age, tumor diameter, tumor location and hepatitis B showed no significant differences(P>0.05). Positive rates of serum CEA and CA19-9 in CRC patients with poorly differentiated and stage Ⅲ~Ⅳ were significantly higher than those with middle and well differentiated and stage Ⅰ~Ⅱ(P<0.01). The 3-year overall survival of liver metastasis CRC patients with positive CEA and CA19-9 was significantly better than that with positive CEA or CA19-9(P<0.05). Conclusion The levels of serum CEA and CA19-9 are helpful to determine the presence of liver metastasis in CRC patients and combined detection of serum CEA and CA19-9 is important for predicting CRC liver metastasis and prognosis.