血清AGR、CEA、CA199与直肠癌根治术后患者预后的关系

Relationship between Serum AGR,CEA,CA199 and Prognosis of Postoperative Patients with Rectal Cancer

目的:探讨血清白蛋白/球蛋白比值(AGR)、癌胚抗原(CEA)、糖类抗原199(CA199)对直肠癌根治术后患者预后的价值。方法:选取我院2021年1月至2023年6月行直肠癌根治术患者86例,根据患者预后情况分为不良组(复发)31例和良好组(未复发)55例。收集2组患者的临床资料,检测2组患者血清AGR、CEA、CA199水平,采取多因素Logistic回归分析直肠癌患者预后的相关危险因素,并通过受试者工作特征曲线(ROC)评价血清AGR、CEA、CA199对直肠癌患者预后的预测价值。结果:不良组患者的肿瘤直径、淋巴结转移比例、血清CEA、CA199水平均大于或高于良好组(P<0.05),血清AGR水平低于良好组(P<0.05)。经多因素Logistic回归分析结果显示,淋巴结转移、血清AGR、CEA、CA199水平是直肠癌根治术不良预后的危险因素(P<0.05)。ROC曲线显示,血清AGR、CEA、CA199单独预测直肠癌根治术预后的AUC分别为0.687、0.724、0.804,三者联合预测的AUC为0.870,大于三者血清指标单独预测。结论:术前血清AGR、CEA、CA199水平是直肠癌根治术后不良预后的危险因素,对预后具有预测价值,且联合检测预测价值最高,对直肠癌根治术患者不良预后的早期防治有参考价值。

Objective To investigate the prognostic value of serum albumin/globulin ratio(AGR),carci-noembryonic antigen(CEA)and carbohydrate antigen 199(CA199)in postoperative patients with rectal cancer.Methods A total of 86 patients who underwent radical resection of rectal cancer in our hospital from January 2021 to June 2023 were selected and divided into unfavorable group(31 cases)and favorable group(55 cases)according to the prognosis.Clinical data of patients in both groups were collected,and the serum levels of AGR,CEA and CA199 were detected in both groups.Risk factors related to prognosis of patients with rectal cancer were analyzed by using multivariate Logistic regression,and the predictive value of serum AGR,CEA and CA199 for prognosis of patients with rectal cancer was evaluated by receiver oper-ating characteristic curve(ROC).Results The tumor diameter,lymph node metastasis ratio,serum lev-els of CEA and CA199 in the unfavorable group were greater or higher than those in the favorable group(P<0.05),and the serum level of AGR was lower than that in the favorable group(P<0.05).Multi-variate Logistic regression analysis showed that lymph node metastasis,serum levels of AGR,CEA and CA199 were risk factors for poor prognosis after radical resection of rectal cancer(P<0.05).ROC curve showed that the AUC of serum AGR,CEA and CA199 in separately predicting the prognosis of radical re-section of rectal cancer was 0.687,0.724 and 0.804,respectively,and the AUC of the combined prediction of the three was 0.870,which was greater than those of the separate prediction of the three serum indexes.Conclusion Preoperative serum levels of AGR,CEA and CA199 are risk factors for unfavorable progno-sis after radical resection of rectal cancer,and have predictive value for prognosis.The combined detection has the highest predictive value,and provide reference for early prevention and treatment of unfavorable prognosis in patients with radical resection of rectal cancer.