中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (11): 827-832.doi: 10.19401/j.cnki.1007-3639.2018.11.005

• 论著 • 上一篇    下一篇

癌胚抗原和糖类抗原19-9对Ⅱ~Ⅲ期结肠癌复发的预测价值

林雪丹1,2,杨天兴2,陶志华1   

  1. 1. 浙江大学医学院附属第二医院检验科,浙江 杭州 310009 ;
    2. 浙江省三门县中医院检验科,浙江 台州 317100
  • 出版日期:2018-11-30 发布日期:2018-12-14
  • 通信作者: 陶志华 E-mail:zrtzh@zju.edu.cn

Predictive value of CEA and CA19-9 for recurrence in stage Ⅱ-Ⅲ colon cancer

LIN Xuedan1,2, YANG Tianxing2,TAO Zhihua1   

  1. 1. Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China; 2. Department of Laboratory Medicine, Sanmen Hospital of Traditional Chinese Medicine, Taizhou 317100, Zhejiang Province, China
  • Published:2018-11-30 Online:2018-12-14
  • Contact: TAO Zhihua E-mail: zrtzh@zju.edu.cn

摘要: 背景与目的:Ⅱ~Ⅲ期结直肠癌患者根治术后约有1/3出现复发转移,影响患者预后。该研究旨在评估癌胚抗原(carcinoembryonic antigen,CEA)和糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)对Ⅱ~Ⅲ期结肠癌患者根治术后复发的预测价值。方法:回顾性分析2012—2013年收治的168例Ⅱ~Ⅲ期结肠癌患者的临床病理和随访资料,均接受根治术,根据术前和术后血清CEA和CA19-9结果将患者分成3组。结果:CEA(H)组的无复发生存率显著低于CEA(HN)组和CEA(N)组(7.4% vs 52.5% vs 75.0%,P=0.000),CA19-9(H)组的无复发生存率显著低于CA19-9(HN)组和CA19-9(N)组(7.1% vs 50.0% vs 61.9%,P=0.000);COX比例风险回归模型多因素分析显示,CEA(H)组、CEA(HN)组、CA19-9(H)组及淋巴结转移是Ⅱ~Ⅲ期结肠癌根治术后复发的独立危险因素。结论:血清CEA和CA19-9可以作为Ⅱ~Ⅲ期结肠癌患者预测复发、协助TNM分期判断预后的重要指标。

关键词: 结肠肿瘤, 复发, 危险因素, 癌胚抗原, 糖类抗原19-9

Abstract: Background and purpose: About one third of patients with stage Ⅱ-Ⅲ colorectal cancer suffer a recurrence after radical surgery, which affects the prognosis of patients. This study aimed to evaluate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in predicting and monitoring the recurrence of stage Ⅱ-Ⅲ colon cancer patients after radical surgery. Methods: The clinicopathological and follow-up data collected from 168 patients who underwent radical resection of stage Ⅱ-Ⅲ colon cancer from 2012 to 2013 were analyzed retrospectively. The patients were divided into 3 groups based on the results of serum CEA and CA19-9 before and after surgery. Results: The recurrence-free survival rate in the CEA (H) group was lower than in the CEA (HN) group and CEA (N) group (7.4% vs 52.5% vs 75.0%, P=0.000). The recurrence-free survival rate in the CA19-9 (H) group was lower than in the CA19-9 (HN) group and CA19-9 (N) group (7.1% vs 50.0% vs 61.9%, P=0.000). Multivariate analysis showed that CEA (H) group, CEA (HN) group, CA19-9 (H) group and lymph node metastasis were independent risk factors for recurrence after radical resection in stage Ⅱ-Ⅲ colon cancer patients. Conclusion: Serum CEA and CA19-9 can be used as predictive factors for recurrence in stage Ⅱ-Ⅲ colon cancer patients and assist in the TNM staging for prognosis of the patients.

Key words: Colonic neoplasms, Recurrence, Risk factors, Carcinoembryonic antigen, Carbohydrate antigen 19-9