血清AGR、CEA、CA199及MIC-1表达在老年结直肠癌诊断及预后评估中的应用价值

Application Value of Serum AGR,CEA,CA199 and MIC-1 Expression in the Diagnosis and Prognosis Evaluation of Elderly Colorectal Cancer

目的:研究血清白蛋白/球蛋白比值(AGR)、癌胚抗原(CEA)、糖类抗原(CA)199及巨噬细胞抑制细胞因子-1(MIC-1)表达在老年结直肠癌诊断及预后评估中的应用价值。方法:选取2020年3月-2022年12月我院收治的老年结直肠癌患者60例作为观察组,根据患者预后情况分为预后良好组(36例)和预后不良组(24例),选取同期来我院体检的健康者58例作为对照组。比较观察组、对照组患者AGR、CEA、CA199、MIC-1表达水平,比较预后良好组和预后不良组AGR、CEA、CA199、MIC-1表达水平、一般临床资料,采用Logistic回归模型分析AGR、CEA、CA199及MIC-1表达与老年结直肠癌患者预后结局的关系。结果:预后良好组和预后不良患者既往靶向治疗、性别、年龄、肿瘤家族史、肿瘤位置、肿瘤距肛缘距离比较,差异无统计学意义(P>0.05),预后良好组患者高分化、TNM分期ⅠⅡ期、淋巴结转移比例低于预后不良组,差异有统计学意义(P<0.05),预后良好组AGR高于预后不良组,差异有统计学意义(P<0.05),预后良好组CA199、CEA水平、MIC-1表达阳性较预后不良组更低,差异有统计学意义(P<0.05)观察组患者AGR低于对照组,差异有统计学意义(P<0.05),观察组CA199、CEA水平、MIC-1表达阳性比例高于对照组,差异有统计学意义(P<0.05),Logistic回归分析结果为TNM分期、AGR、CEA、CA199是老年结直肠癌患者预后的影响因素(P<0.05)。Logistic回归模型联合预测老年结直肠癌患者预后不良的ROC曲线下面积为0.954,显著高于各指标单独预测ROC曲线下面积0.683、0.866、0.918、0.909(P<0.05)。结论:血清AGR降低,CEA、CA199水平升高与老年结直肠癌预后不良有关,各指标联合预测老年结直肠癌患者预后不良有较好的应用价值。

Objective:To study the value of serum albumin/globulin ratio(AGR),carcinoembryonic antigen(CEA),glycoantigen(CA)199 and macrophage inhibitory cytokine-1(MIC-1)expression in the diagnosis and prognostic evaluation of elderly colorectal cancer.Methods:60 cases of elderly colorectal cancer patients admitted to our hospital from March 2020 to December 2022 were selected as the observation group.According to the prognosis of patients,they were divided into good prognosis group(36 cases)and poor prognosis group(24 cases),and 58 healthy patients to our hospital for physical examination in the same period were selected as the control group.We compared AGR,CEA,CA199 and MIC-1 expression levels in the observation and control groups,compared the AGR,CEA,CA199,1 and MIC-1 expression levels,general clinical data between the good and poor prognosis groups,and analyzed the relationship between AGR,CEA,CA199 and MIC-1 expression and prognostic outcome in elderly colorectal cancer patients by Logistic regression model.Results:Comparison of previous targeted therapy,gender,age,tumor family history,tumor location,distance between tumor and anal margin in patients with poor prognosis,Not statistically significant difference(P>0.05),Patients in the good prognosis group with high differentiation,TNM stageⅠⅡand lymph node metastasis were lower than the poor prognosis group,Statistically significant difference(P<0.05),The AGR in the good prognosis group was higher than that in the poor prognosis group,Statistically significant difference(P<0.05),CA199,CEA level,and positive MIC-1 expression were lower than those in the poor prognosis group,Statistically significant(P<0.05)observation group patients had lower AGR than the control group,Statistically significant difference(P<0.05),The proportion of CA199,CEA level and positive MIC-1 expression were higher than those in the control group,Statistically significant difference(P<0.05),Logistic The regression analysis showed TNM stage,AGR,CEA,and CA199 as the factors influencing the prognosis of elderly colorectal cancer patients(P<0.05).The ROC area under the curve of Logistic regression model jointly predicting poor prognosis in elderly colorectal cancer patients was 0.954,which was significantly higher than the area of 0.683,0.866,0.918,and 0.909(P<0.05).Conclusion:Decreased serum AGR and increased CEA and CA199 levels are related to poor prognosis in elderly colorectal cancer,and the combination of various indicators can predict poor prognosis in elderly colorectal cancer patients.