中低位局部进展期直肠癌新辅助同步放化疗患者癌胚抗原检测的意义

The Significance of Detecting their CEA Levels for the Patients with Mid-and Low Locally Advanced Rectal Cancer and Undergoing Synchronized Neoadjuvant Chemoradiotherapy

目的:探讨中低位局部进展期直肠癌接受新辅助同步放化疗的患者检测癌胚抗原(CEA)的临床意义。方法:以2018年1月至2019年12月于我院接受新辅助同步放化疗后择期行直肠癌根治术的78例中低位局部进展期直肠癌患者为研究对象,患者放化疗前后均接受CEA水平检测。以术后病理检查结果判定新辅助放化疗治疗效果,分析放化疗前CEA水平以及放化疗前后CEA下降水平与放化疗疗效的关系。结果:本组78例患者中,病理完全缓解(pCR,TRG4级)14例(17.95%),TRG3级11例(14.10%),TRG2级13例(16.67%),TRG0、TRG1级共40例(51.28%)。新辅助放化疗前CEA水平为(5.19±1.62)μg/L,放化疗后为(2.62±0.73)μg/L(P<0.05);放化疗前CEA水平≤5.0μg/L者pCR 11例(34.38%,11/32),>5.0μg/L者pCR 3例(6.52%,3/46)(P<0.05);放化疗后CEA水平下降≥50%者pCR 12例(31.58%,12/38),CEA水平下降<50%者pCR 2例(5.00%,2/40)(P<0.05)。结论:新辅助放化疗前CEA水平越低、放化疗后CEA水平降低幅度越大的直肠癌患者pCR率越高。提示检测放化疗前后CEA水平有助于辅助评估临床疗效。

Objective To explore the significance of detecting their CEA levels for the patients with midand low locally advanced rectal cancer and undergoing synchronized neoadjuvant chemoradiotherapy.Methods The 78cases met above conditions from authors’hospital(2018-01-2019-12)were enrolled in this study:they all received CEA levels detection before and after chemoradiotherapy,the therapeutic effects were judged according to postoperative pathological exam.results;then,the relation of CEA levels before chemoradiotherapy with the effect,as well as the relation of the declined levels status between before and after chemoradiotherapy with the effect were analysed.Results In the 78cases,14were in pCR(TRG4Grade,accounted for 17.95%),11in TRG3 Grade(14.10%),13in TRG2 Grade(16.67%),40(51.28%)in TRG0and TRG1Grade;before the therapy CEA level was(5.19±1.62)μg/L,after one,was(2.62±0.73)μg/L,thus,P<0.05.As for before chemoradiotherapy,those whose CEA level≤5.0μg/L,including 11cases for pCR(11/32,34.38%);those whose CEA levels>5.0μg/L,including 3cases of pCR(3/46,6.52%),thus the difference between both was P<0.05.As for after chemoradiotherapy,those whose CEA levels declined≥50%,including 12cases of pCR(12/38,31.58%);those whose CEA levels declined<50%,including 2cases of pCR(2/40,5.00%),thus,P<0.05between both the difference was P<0.05.Conclusion The patients,more lower their CEA levels before chemoradiotherapy are,and more larger their CEA levels declined contents are,have more higher pCR ratio,which suggest detecting CEA levels befored and after chemoradiotherapy is helpful to evaluate clinical effect.