血清α-HBDH、CYFRA211水平变化与结直肠癌临床分期及其预后的关系分析

Relationship Between the Changes of Serumα-HBDH and CYFRA211 Levels and Clinical Stages and The Prognosis of Colorectal Cancer

目的探讨结直肠癌患者血清α-羟丁酸脱氢酶(α-HBDH)、细胞角蛋白19的可溶性片段(CYFRA211)水平变化与其临床分期及预后的关系。方法回顾性收集152例结直肠癌患者临床资料作为研究组,另选取同时期152例健康者体检资料为对照组,检测并比较两组血清α-HBDH、CYFRA211水平,分析TNM肿瘤Ⅰ~Ⅳ期患者α-HBDH、CYFRA211水平,比较不同预后患者两指标水平,分析预后影响因素并评估α-HBDH、CYFRA211两血清指标与其预后的关系。结果研究组血清α-HBDH、CYFRA211水平均明显高于对照组(P<0.05);随着肿瘤分期增加,α-HBDH水平上升越明显,不同分期患者对比差异显著(P<0.05),Ⅰ~Ⅱ期患者CYFRA211水平比较无统计学差异(P>0.05),Ⅲ~Ⅳ期患者CYFRA211水平明显上升且Ⅳ期明显高于Ⅲ期(P<0.05)。经单因素与多因素回归分析,血清α-HBDH、CYFRA211水平、TNM分期为患者短期预后的独立影响因素(P<0.05);血清α-HBDH、CYFRA211水平预测预后不良的ROC曲线下面积依次为0.919、0.797,特异性为98.15%、97.22%,灵敏度依次为为81.82%、65.91%,具有一定预测价值(P<0.05)。结论结直肠癌患者血清α-HBDH、CYFRA211水平较高,且与临床分期短期预后相关,对短期预后具有一定预测价值。

Objective To investigate the relationship between the changes of serum α-hydroxybutyrate dehydrogenase(α-HBDH)and cytokeratin 19 fragment(CYFRA211)and clinical stages and the prognosis of colorectal cancer.Methods 152 patients with colorectal cancer were selected as the study group.At the same time,152 healthy individuals were selected as the control group.Serumα-HBDH and CYFRA211 levels in the 2 groups were compared.Serumα-HBDH and CYFRA211 levels in patients at TNM stage Ⅰ~Ⅳ were analyzed.Serum α-HBDH and CYFRA211 levels in patients with different prognosis were compared.The prognostic factors were analyzed.The relationship between serum indicators(α-HBDH and CYFRA211)and the prognosis was discussed.Results Serum α-HBDH and CYFRA211 levels in the study group were significantly higher than those in the control group(P<0.05).As the tumor stage increased,α-HBDH level increased,with significant differences between different stages(P<0.05).There was no statistically significant difference in CYFRA211 level in stages Ⅰ~Ⅱ(P>0.05).CYFRA211 level was significantly higher in stage Ⅲ~Ⅳ,and were significantly higher in stageⅣthan in stage Ⅲ(P<0.05).Univariate analysis and multivariate regression analysis found that serumα-HBDH and CYFRA211 levels,and TNM staging were independent influencing factors of the short-term prognosis(P<0.05).The area under the receiver operating characteristic(ROC)curve values of serum α-HBDH and CYFRA211 levels to predict poor prognosis were 0.919 and 0.797.The specificity was 98.15% and 97.22%.The sensitivity was 81.82% and 65.91%(P<0.05).Conclusion Serum α-HBDH and CYFRA211 levels in patients with colorectal cancer are relatively high,and are related to clinical stages and the short-term prognosis.The two are of certain value in predicting the short-term prognosis.