术前CEA、D-二聚体、纤维蛋白原与结直肠癌临床病理特点、分期及预后相关性研究

Study on the correlation between preoperative CEA,D-dimer,fibrinogen and clinicopathological features,stage and prognosis of colorectal cancer

目的分析术前癌胚抗原(CEA)、D-二聚体、纤维蛋白原(FIB)与结直肠癌临床病理特点、分期及预后相关性,探讨CEA、D-二聚体和FIB术前检测在结直肠癌诊疗中的应用价值。方法收集2009年7月至2011年7月该院收治结直肠癌患者158例病理资料,术前检测血浆CEA、D-二聚体和FIB水平,随访并观察所有患者5年生存率,分析血浆CEA、D-二聚体和FIB水平与结直肠癌临床病理特点、TNM分期及预后关系。结果术前158例患者血浆CEA、D-二聚体和FIB水平分别为(4.41±0.84)ng/mL、(0.48±0.13)mg/L和(3.72±0.73)g/L。术前血浆CEA、D-二聚体和FIB水平与肿瘤大小、淋巴结转移相关(P<0.05),与性别、年龄、肿瘤部位、分化程度无关(P>0.05);术前血浆CEA、D-二聚体和FIB水平均与结直肠癌TNM分期相关(P<0.05),经相关性分析,术前血浆CEA、D-二聚体和FIB水平与TNM分期呈正相关(r=0.67,r=0.81,r=0.64,P<0.05);经单因素分析,术前血浆CEA、D-二聚体和FIB水平均是影响术后5年生存率的危险因素(P<0.05),经多因素分析,术前血浆CEA、D-二聚体和FIB水平是影响术后5年生存率的独立危险因素(P<0.05)。结论术前血浆CEA、D-二聚体和FIB水平和结直肠癌临床病理特点及分期相关,高水平CEA、D-二聚体和FIB患者5年生存率较低,是影响预后的独立危险因素。

Objective To analyze the correlation between preoperative carcinoembryonic antigen(CEA),Ddimer,fibrinogen(FIB)and the clinicopathological features,stage and prognosis of colorectal cancer(CRC),and evaluate the application value of CEA,D-dimer and FIB in the diagnosis and treatment of CRC.Methods The pathological files of 158 patients with CRC treated in a hospital from July 2009 to July 2011 were collected.The levels of plasma CEA,D-dimer and FIB were detected before operation.All patients were followed up for a period of 5 years.The relationships between plasma CEA,D-dimer and FIB levels and clinicopathological features,TNM stage and prognosis of CRC were analyzed.Results Before operation,the levels of plasma CEA,D-dimer and FIB were(4.41±0.84)ng/mL,(0.48±0.13)mg/L and(3.72±0.73)g/L,respectively.The preoperative plasma CEA,D-dimer and FIB level were related to tumor size and lymph node metastasis(P<0.05),and have nothing to do with gender,age,tumor site,degree of differentiation(P>0.05),preoperative levels of plasma CEA,D-dimer and FIB were related to TNM stage of CRC(P<0.05).By correlation analysis,the preoperative levels of CEA,D-dimer and FIB in the plasma were positively correlated with the stage of TNM(r=0.67,r=0.81,r=0.64,P<0.05).Univariate analysis showed that preoperative plasma CEA,D-dimer and FIB were the risk factors for postoperative 5-year survival rate(P<0.05).Multivariate analysis showed that preoperative levels of CEA,D-dimer and FIB in the plasma were independent risk factors for the 5-year survival rate(P<0.05).Conclusion Preoperative plasma CEA,D-dimer and FIB levels are correlated with the clinicopathological features and stage of CRC.The 5-year survival rate of patients with high levels of CEA,D-dimer and FIB is low,and plasma CEA,D-dimer and FIB are the independent risk factors influencing the prognosis.