结肠癌肝转移介入治疗后血清CEA、VEGF、MMP-9水平与预后的相关性

Correlation between serum CEA,VEGF,MMP-9 levels and prognosis after interventional therapy for liver metastasis of colon cancer

目的探讨结肠癌肝转移患者经导管肝动脉化疗栓塞(TACE)治疗后血清癌胚抗原(CEA)、血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP-9)水平及与预后关系。方法选取2014年5月至2016年5月新疆喀什地区第二人民医院接受TACE治疗的95例初治结肠癌肝转移患者作为研究对象。采用酶联免疫吸附试验(ELISA)双抗体夹心法检测血清CEA、VEGF、MMP-9水平,分析血清CEA、VEGF、MMP-9水平与结肠癌肝转移患者3年总生存率(OS)关系,并采用COX回归分析影响结肠癌肝转移患者预后的危险因素。结果结肠癌肝转移患者TACE治疗后血清CEA、VEGF、MMP-9水平均显著低于TACE治疗前(P<0.05)。TACE治疗后血清CEA、VEGF、MMP-9水平与结肠癌肝转移患者性别、年龄及肿瘤长径无关(P>0.05);而与患者肿瘤部位、大体分型及TNM分期有关(P<0.05)。随访3年后95例结肠癌肝转移患者OS为45.26%,生存分析发现TACE治疗后血清CEA水平≥5 μg/L患者3年OS明显低于血清CEA水平<5 μg/L患者(P<0.05),血清VEGF水平≥269 mg/L患者3年OS明显低于血清VEGF水平<269 mg/L患者(P<0.05),血清MMP-9水平≥192 mg/L患者3年OS明显低于血清MMP-9水平<192 mg/L患者(P<0.05)。COX多因素分析发现,TACE治疗后血清CEA、VEGF、MMP-9水平均是影响结肠癌肝转移患者预后的独立危险因素(P<0.05)。结论结肠癌肝转移患者TACE治疗后血清CEA、VEGF、MMP-9水平均明显降低,揭示此三种分子可能作为结肠癌肝转移预后评价的指标。

Objective To investigate the levels of serum carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)and their relationships with prognosis in patients with liver metastasis from colon cancer after transcatheter arterial chemoembolization(TACE).Methods 95 patients with liver metastasis from colon eancer who received TACE treatment in Kashgar Prefecture Second People's Hospital from May 2014 to May 2016 were selected as the study subjects.The serum levels of CEA,VEGF and MMP-9 were detected by enzyme-linked immunosorbent assay(ELISA).The relationship between serum CEA,VEGF,MMP.9 levels and 3-year overall survival rate(OS)of patients with liver metastasis of colon cancer was analyzed.The risk factors of prognosis in patients with liver metastasis of colon cancer were analyzed by COX regression analysis.Results The levels of serum CEA,VEGF and MMP-9 in patients with liver metastasis of colon cancer after TACE treatment were significantly lower than those before TACE treatment(P<0.05).The serum CEA,VEGF and MMP-9 levels after TACE treatment were not related to gender,age and tumor diameter of patients with liver metastasis of colon cancer(P>0.05),but related to tumor location,gross classification and tumor node metastasis(TNM)stage(P<0.05).After 3 years of fllow-up,the OS of 95 patients with liver metastasis from colon cancer was 45.26%,Survival analysis showed that the OS of patients with serum CEA level≥5μg/L after TACE treatment was significantly lower than that of patients with serum CEA level<5μg/L(P<0.05).The OS of patients with serum VEGF level≥269 mg/L was significantly lower than that of patients with serum VEGF level<269 mg/L(P<0.05).The OS of 3-year patients with serum MMP-9 level≥192 mg/L was significantly lower than that of patients with serum MMP-9 level<192 mg/L(P<0.05).COX multivariate analysis showed that serum CEA,VEGF and MMP9 levels after TACE treatment were independent risk factors for the prognosis of patients with liver metastasis of colon cancer(P<0.05).Conclusions The serum CEA,VEGF and MMP-9 levels in patients with liver metastasis from colon cancer after TACE treatment are significantly decreased,which can be used as serum markers to judge prognosis.