术前联合检测癌胚抗原和CD44v6对判断结直肠癌患者预后的价值  

Prognostic value of combined examination of pre-operative carcinoembryonic antigen and CD44v6 for judging colorectal cancer

作　　者：颜兵[1] 杨涛[1] 薛天慧 徐睿 游俊浩[1] Yan Bing;Yang Tao;Xue Tianhui;Xu Rui;You Junhao(Department of Oncology,Hainan Hospital of PLA General Hospital,Sanya 572000,China)

机构地区：[1]解放军总医院海南医院肿瘤科,海南三亚572000

出　　处：《肿瘤研究与临床》2018年第11期744-748,共5页Cancer Research and Clinic

基　　金：国家自然科学基金(81503391);海南省自然科学基金面上项目(817352);三亚市医疗卫生创新项目(2016YW08、2018YW06).

摘　　要：目的 评价术前联合检测癌胚抗原(CEA)和CD44v6对结直肠癌患者预后判断的价值。方法 收集解放军总医院海南医院2012年12月至2017年12月就诊的经病理确诊且具备完整临床资料的结直肠癌患者140例,依据术前CEA检测和CD44v6免疫组织化学结果,排除单独CEA(-)或CD44v6(-)患者,最终纳入患者69例,采用电化学发光法检测患者术前1个月内CEA值、免疫组织化学SP法检测CD44v6;采用Kaplan-Meier法对疾病无进展生存(PFS)时间进行单因素分析,采用Cox比例风险模型行多因素分析。结果 69例患者中CEA和CD44v6双阳性29例,双阴性40例。不同性别、M分期、TNM分期患者的双阳性/双阴性表达差异有统计学意义,双阳性更常见于女性(χ^2=4.42,P=0.04)、有转移(χ^2=5.06,P=0.02)和晚期(χ^2=4.38,P=0.04)患者;单因素分析结果显示N分期(P=0.00)、M分期(P=0.00)、TNM分期(P=0.00)和CEA、CD44v6双阳性/双阴性(P=0.04)影响患者的PFS,多因素分析结果显示N分期(HR=0.15,95%CI0.03~0.86,P=0.03)、TNM分期(HR=23.83,95%CI3.65~155.51,P=0.00)是影响患者PFS时间的独立预后因素。双阳性患者相比双阴性患者PFS时间更短[24.0个月(3~84个月)比31.0个月(8-94个月),P=0.04]。结论 CEA和CD44v6术前联合检测对判断结直肠癌患者预后可能存在一定价值。Objective To evaluate the prognostic value of combined examination of pre-operative carcinoembryonic antigen (CEA) and CD44v6 for colorectal cancer patients. Methods A total of 140 patients with complete clinical data pathologically diagnosed as colorectal cancer from December 2012 to December 2017 in Hainan Hospital of PLA General Hospital were enrolled. Finally, 69 validated cases excluding CEA (-) or CD44v6(-) patients were registered according to pre-operative CEA detection and immunohistochemistry results of CD44v6. Kaplan-Meier method was used to analyze the progression-free survival (PFS) time for single factors. Multiple-factor analysis was done by using Cox proportional hazard model. Results Sixty-nine patients included 29 cases of double positive and 40 cases of double negative in CEA and CD44v6. There were statistical significances of the expressions of double positive and double negative in patients with different gender, M stage, TNM stage. Double positive was more apparent in female (χ^2 = 4.42, P= 0.04), presenting of metastasis (χ^2=5.06, P=0.02) and advanced cases (χ^2=4.38, P= 0.04); univariable analysis showed the N stage (P=0.00), M stage (P=0.00), TNM stage (P=0.00) and double positive/double negative in CEA and CD44v6 (P= 0.04) were likely to affect the PFS, however, multivariable analysis showed that N stage (HR= 0.15, 95 % CI: 0.03-0.86, P= 0.03), TNM stage (HR= 23.83, 95 % CI: 3.65-155.51, P=0.00) were the independent prognostic factors for PFS. PFS in double positive patients was shorter than that in double negative ones [24.0 months (3-84) vs. 31.0 months (8-94), P=0.04]. Conclusion Pre-operative combined examination of CEA and CD44v6 could be helpful in judging the prognosis for colorectal cancer patients.

关 键 词：结直肠肿瘤 癌胚抗原 抗原 CD44V6 肿瘤分期 预后 

分 类 号：R735.34[医药卫生—肿瘤]