摘要
目的探讨术后与术前癌胚抗原比值(CEA比值)对术前CEA升高结直肠癌患者预后评估的价值。方法对133例术前CEA升高的结直肠癌患者的临床、病理及随访资料进行收集,采用Ka-plan-Meier法计算累积生存率并绘制生存曲线、Log-rank检验比较生存率、Cox回归寻找影响结直肠癌患者预后的独立危险因素,分析CEA比值的大小与结直肠癌患者预后的关系。结果 133例中男86例、女47例,年龄58 (15～88)岁,中位随访时间31 (2～96)个月,失访9例,随访率93.2%,死亡83例,病死率62.4%。生存分析结果显示,年龄≥60岁、肿瘤直径≥5 cm、神经侵犯、合并肠梗阻、淋巴结转移、远处转移、TNM分期为Ⅲ/Ⅳ期、术后CEA阳性(≥5μg/l)、CEA比值≥1的结直肠癌患者总生存率均明显降低,差异有统计学意义(P均<0.05)。CEA比值越低,生存率越高(P<0.001)。Cox回归结果提示CEA比值是影响预后的独立危险因素(HR=6.482,95%CI:3.732～11.257,P<0.001)。结论 CEA比值可为判断术前CEA升高的结直肠癌患者预后提供重要信息。
Objective To investigate the prognostic value of the postoperative to preoperative carcinoembryonic antigen(CEA)ratio in colorectal cancer patients with positive preoperative CEA.Methods Clinicopathological and follow-up data of133colorectal cancer patients with positive preoperative CEA level were collected.Kaplan-Meier method was adopted to calculate the cumulative survival rate and plot the survival curve.Log-rank test was utilized to compare the survival rate.Cox’s regression model was employed to identify the independent risk factors affecting the prognosis of colorectal cancer patients and analyze the relationship between the CEA ratio and clinical prognosis of colorectal cancer patients.Results Among133cases,86patients were male and47female,aged58years on average(range:15-88years).The median follow-up time was31months(range:2-96months).Nine cases were lost to follow-up.The follow-up rate was calculated as93.2%.Eighty-three patients died with a mortality rate of62.4%.Survival analysis demonstrated that the overall survival rates of colorectal cancer patients with age≥60years,tumor diameter≥5cm,nerve invasion,complicated with intestinal obstruction,lymph node metastasis,distant metastasis,TNM stageⅢ/Ⅳ,positive CEA(≥5μg/L)after operation and CEA ratio≥1were significantly lower(allP<0.05).The lower the CEA ratio,the higher survival rate(P<0.001).Cox’s regression model revealed that CEA ratio was an independent risk factor affecting the clinical prognosis(HR=6.482,95%CI:3.732-11.257,P<0.001).Conclusion Postoperative to preoperative CEA ratio can provide pivotal evidence for evaluating the clinical prognosis of colorectal cancer patients with positive preoperative CEA.
作者
黄利军
邵军
郑宗珩
Huang Lijun;Shao Jun;Zheng Zongheng(Department of Gastrointestinal Surgery,the Third Affiliated Hospital of Sun Yat?sen University,Guangzhou 510630,China)
出处
《新医学》
2018年第12期873-877,共5页
Journal of New Medicine
基金
国家自然科学基金面上项目(81472825)
广东省科技计划项目(2015A020210044，2014A020209022)
吴阶平医学基金会临床科研专项资助基金(320.2710.1822)
关键词
结直肠肿瘤
癌胚抗原
预后
Colorectal neoplasm
Carcinoembryonic antigen
Prognosis
作者简介
通讯作者,郑宗珩.
