围术期血清癌胚抗原、糖类抗原19-9及其比值对结直肠癌患者术后预后的临床价值

Clinical value of perioperative serum carcinoembryonic antigen,carbohydrate antigen 19-9 and their ratio on postoperative prognosis of patients with colorectal cancer

目的探讨围术期血清癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)及其比值对结直肠癌(colorectal cancer,CRC)患者术后预后的临床价值。方法选取2015年2月至2017年2月四川省成都市第三人民医院行手术治疗的198例CRC患者为研究对象,分析患者CEA、CA19-9及其比值与CRC患者的病理参数和生存预后关系,并分析影响CRC患者预后的危险因素。结果有肿瘤远处转移、TNM分期Ⅲ~Ⅳ期患者,术前CEA升高;有肿瘤远处转移、TNM分期Ⅲ~Ⅳ期、T分期T3~T4、有淋巴结转移、肿瘤中高分化患者,术前CA19-9升高;有肿瘤远处转移、TNM分期Ⅲ~Ⅳ期的患者,术后CEA升高;有肿瘤远处转移、TNM分期Ⅲ~Ⅳ期和有淋巴结转移患者,术后CA19-9升高;术后CEA升高、术前CA19-9升高、术后CA19-9升高、术后CEA/术前CEA比值>1、术后CA19-9/术前CA19-9比值>1的患者术后3年总生存期缩短(P<0.05);术前CA19-9升高、术后CEA/术前CEA比值>1、术后CA19-9/术前CA19-9比值>1、淋巴结转移、肿瘤远处转移是影响CRC患者术后预后的独立危险因素。结论术前CA19-9升高、术后CEA/术前CEA比值>1、术后CA19-9/术前CA19-9比值>1属于影响CRC患者术后预后的独立危险因素。

Objective To investigate the clinical value of perioperative serum carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and their ratio on postoperative prognosis of patients with colorectal cancer(CRC).Method we selected February 2015 to February 2017 in our line of surgical treatment of 198 cases of CRC patients as the research object,analyzed the CEA and CA19-9 patients and their ratio relation with the pathological parameters and survival prognosis of CRC patients,and analyze the risk factors affecting the prognosis of patients with CRC.Result There were significant differences between preoperative CEA positive and distant metastasis and TNM stage.There was significant difference between CA19-9 positive before surgery and distant metastasis,TNM stage,depth of tumor invasion,lymph node metastasis and degree of tumor differentiation.Postoperative CEA positive was significantly correlated with distant metastasis and TNM stage.Postoperative CA19-9 positive was significantly correlated with distant metastasis,TNM stage and lymph node metastasis.The postoperative CEA positive,the preoperative CA19-9 positive,the postoperative CA19-9 positive,the CEA ratio>1,the CA19-9 ratio BBB>and the postoperative 3-year overall survival of CRC patients were significantly shortened(P<0.05).Preoperative positive CA19-9,CEA ratio>1,CA19-9 ratio>1,lymph node metastasis and distant tumor metastasis were independent risk factors affecting postoperative prognosis of patients with CRC.Conclusion Preoperative CA19-9 elevation,postoperative CEA/preoperative CEA ratio>1,postoperative CA19-9/preoperative CA19-9 ratio>1 are independent risk factors affecting postoperative prognosis of patients with CRC.