HBsAg、CEA及CA19-9在结直肠癌肝转移诊断及预后转归中的价值

Values of HBsAg, CEA and CA19-9 in the diagnosis and prognosis of colorectal cancer with liver metastasis

目的分析乙肝表面抗原(HBsAg)、癌胚抗原(CEA)及糖类抗原19-9(CA19-9)在结直肠癌肝转移的诊断及预后转归中的价值。方法将我院2012年7月至2014年7月收治的68例结直肠癌患者根据是否发生肝转移分为肝转移组(n=22)和无肝转移组(n=46)。分析HBsAg、CA19-9、CEA与结直肠癌肝转移的关系,并观察CEA和CA19-9对患者预后转归的影响。结果肝转移组的HBsAg阳性率显著低于无肝转移组,CEA及CA19-9阳性率均显著高于无肝转移组,差异具有统计学意义(P<0.05)。log-rank检验结果显示,CEA阳性组的5年累积生存率显著低于CEA阴性组(P<0.05),CA19-9阳性组5年累积生存率显著低于CA19-9阴性组(P<0.05),HBsAg阳性组5年累积生存率略高于HBsAg阴性组(P>0.05)。结论结直肠癌较少转移至已感染HBV的肝脏。CEA、CA19-9对于预测结直肠癌患者的预后具有较大的临床价值,且CEA、CA19-9阳性检测可作为结直肠癌发生肝转移的早期诊断方法。

Objective To analyze the values of hepatitis B surface antigen(HBsAg), carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9) in the diagnosis and prognosis of colorectal cancer with liver metastasis. Methods Sixty-eight patients with colorectal cancer treated in our hospital from July 2012 to July 2014 were divided into liver metastasis group(n =22) and non-liver metastasis group(n =46) according to whether liver metastasis occured. The relationship between HBsAg, CA19-9, CEA and colorectal cancer with liver metastasis were analyzed, and the effects of CEA and CA19-9 on prognosis were observed. Results The positive rate of HBsAg in the liver metastasis group was significantly lower than that in the non-liver metastasis group, and the positive rates of CEA and CA19-9 were significantly higher than those in the non-liver metastasis group, and the differences were statistically significant(P<0.05).The log-rank test results showed that the 5-year cumulative survival rate of the CEA positive group was significantly lower than that of the CEA negative group(P <0.05), the 5-year cumulative survival rate of the CA19-9 positive group was significantly lower than that of the CA19-9 negative group(P<0.05), and the 5-year cumulative survival rate of the HBsAg positive group was slightly higher than that of the HBsAg negative group(P>0.05). Conclusion Colorectal cancer is less likely to metastasize to the liver which has been infected with HBV. CEA and CA19-9 are of great clinical values in predicting the prognosis of colorectal cancer patients, and the positive detection of CEA and CA19-9 can be used as the early diagnosis method of colorectal cancer with liver metastasis.