血清CEA、CA19-9、CA242对结直肠癌转移及预后的评估价值

Value of Serum CEA,CA19-9 and CA242 in Evaluation of Metastasis and Prognosis of Colorectal Cancer

目的探究血清癌胚抗原(CEA)、糖类多肽抗原19-9(CA19-9)、糖类多肽抗原242(CA242)对结直肠癌转移和预后的评估价值。方法选择2014年2月—2017年1月接受手术治疗的325例结直肠癌患者作为研究对象。测定血清CEA、CA19-9、CA242水平,收集患者临床资料并随访统计患者转移以及预后情况。采用受试者工作特征曲线(ROC)分析血清CEA、CA19-9、CA242预测术后转移的价值,采用生存曲线法分析其与预后的关系。结果转移患者血清CEA、CA19-9、CA242水平均显著高于未转移患者(P<0.01)。血清CEA、CA19-9、CA242单独预测结直肠癌患者术后转移的曲线下面积(AUC)分别为0.799、0.678、0.750,其中CEA预测效能最高;CEA+CA19-9、CEA+CA242、CA19-9+CA242、三者联合预测的AUC分别为0.830、0.870、0.807、0.895,其中三者联合预测效能最高。血清CEA、CA19-9、CA242阴性结直肠癌患者总体生存率显著高于阳性患者(P<0.05)。血清CEA、CA19-9、CA242阳性是影响结直肠癌患者预后的独立危险因素(P<0.05或P<0.01)。结论血清CEA、CA19-9、CA242与结直肠癌患者术后转移及预后密切相关,可单独或联合用于评估患者术后转移风险及预后情况。

Objective To investigate the value of serum carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 242(CA242)in evaluating metastasis and prognosis of colorectal cancer(CRC).Methods A total of 325 patients with CRC who underwent surgical treatment between February 2014 and January 2017 were selected as the research subjects.Serum CEA,CA19-9 and CA242 were measured,the clinical data of the patients were collected and the patients were followed up to statistically analyze metastasis and prognosis of CRC.The value of serum CEA,CA19-9 and CA242 in predicting postoperative metastasis was analyzed by the receiver operating characteristic(ROC)curve,and the relationship between the three indexes and prognosis was analyzed by survival curve.Results Serum CEA,CA19-9 and CA242 in patients with metastases were significantly higher than those without metastases(P<0.01).The area under the curve(AUC)of serum CEA,CA19-9 and CA242 alone in prediction of postoperative metastasis of CRC patients was 0.799,0.678,and 0.750,respectively,of which CEA had the highest prediction efficiency.The AUC of CEA+CA19-9,CEA+CA242,CA19-9+CA242 and the combination of the three in metastasis prediction were 0.830,0.870,0.807 and 0.895,respectively,of which the combination of the three had the highest prediction efficiency.Overall survival rate of CRC patients with positive serum CEA,CA19-9 and CA242 was significantly higher than that of positive patients(P<0.05).Positive serum CEA,CA19-9 and CA242 were independent risk factors that affected the prognosis of CRC patients(P<0.05 or P<0.01).Conclusion Serum CEA,CA19-9 and CA242 are closely related to postoperative metastasis and prognosis of patients with CRC,and can be used alone or in combination to evaluate the risk of postoperative metastasis and prognosis.