术前血清CA19-9和NSE对食管鳞癌患者预后的影响

Prognostic values of preoperative serum CA199 and NSE on esophageal squamous cell carcinoma patients

目的研究术前血清癌抗原19-9(cancer antigen 19-9,CA19-9)和神经元特异性烯醇化酶(neuron-specific enolase,NSE)对食管鳞癌(esophageal squamous cell carcinoma,ESCC)患者预后的影响。方法前瞻性分析176例经病理确诊的食管鳞癌新发病例。应用X^2检验分析CA19-9和NSE与患者一般临床特征之间的关系。运用Kaplan-Meier法绘制生存曲线,通过Log-rank法进行生存率的比较,利用Cox比例风险回归模型进行多因素分析。结果高CA19-9和NSE联合检测组的食管鳞癌患者预后较差(总生存:HR=2. 310,95%CI:1. 209～4. 418;无病生存:HR=2. 354,95%CI:1. 265～4. 381)。相比于两种标志物单独检测,联合检测CA19-9和NSE对食管鳞癌患者生存预测的准确性更高(总生存:C-index=0. 686;无病生存:C-index=0. 684)。结论术前血清CA19-9和NSE是食管鳞癌患者预后的危险因素,联合检测对食管鳞癌患者预后预测的准确性更高。

Objective To explore the effects of preoperative serum cancer antigen 19-9(CA19-9)and neuron-specific enolase(NSE)on the prognosis of patients with esophageal squamous cell carcinoma(ESCC).Methods This prospective study enrolled 176 patients with ESCC.X^2 test was used to analyze the relationship between CA19-9,NSE and general clinical features.Survival curves were estimated using Kaplan-Meier method and comparisons were performed using the log-rank test.The Cox proportional hazards model was performed for multivariate analyses of overall survival(OS)and disease free survival(DFS).Results The patients with both high CA19-9 and NSE had the poor prognosis compared with those had both low CA19-9 and NSE(OS:HR=2.310,95%CI:1.208-4.418;DFS:HR=2.354,95%CI:1.265-4.381).Compared to the separate detection of the two markers,the combined detection of CA19-9 and NSE was more accurate in the prognosis prediction of patients with ESCC(OS:C-index=0.686;DFS:C-index=0.684).Conclusions Preoperative serum CA19-9 and NSE were risk factors for the prognosis of patients with ESCC.Combined detection had higher accuracy of prediction of prognosis in patients with ESCC.