肠癌患者Cyfra21-1与临床病理参数关系回顾性分析  

Correlation of CYFRA21-1 with the clinicopathological parameters in colorectal cancer patients:A retrospective study

作　　者：颜兵[1] 刘辉[1] 游俊浩[1] 李方[1] 

机构地区：[1]解放军总医院海南分院肿瘤科,海南三亚572000

出　　处：《中华肿瘤防治杂志》2017年第7期472-476,共5页Chinese Journal of Cancer Prevention and Treatment

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);三亚市医疗卫生科技创新项目(2016YW08)

摘　　要：目的 Cyfra21-1是常见的血清肿瘤标志物之一,但其在肠癌中的研究较少。本研究旨在分析肠癌患者术前Cyfra21-1水平和临床病理参数的关系。方法收集解放军总医院海南分院2012-06-01-2016-06-01经病理确诊的肠癌患者115例,将患者性别、年龄、肿瘤位置、肿瘤细胞分化程度、TNM分期、微卫星状态、Ki-67指数和危险因素等与Cyfra21-1、CEA水平进行统计分析。结果术前Cyfra21-1和CEA的阳性率分别为38.26%(44/115)和37.39%(43/115),双阳性和仅Cyfra21-1的阳性率均为19.13%(22/115),仅CEA阳性率为18.26%(21/115),双阴性率43.47%(50/115)。术前Cyfra21-1水平在不同的肿瘤细胞分化程度(χ~2=14.47,P<0.001)和M分期(χ~2=4.62,P=0.03)中差异有统计学意义,而术前CEA水平在不同的T(χ~2=17.72,P=0.00)、M(χ~2=7.81,P<0.001)及TNM分期(χ~2=19.26,P<0.001)差异有统计学意义。肿瘤最大径及阳性淋巴结数在两者升高组中均对应升高,均P<0.05。Logistic多因素回归分析提示,对术前Cyfra21-1水平存在重要影响因素的是肿瘤细胞分化程度和肿瘤最大径;相对于低分化,中分化OR=0.17,95%CI为0.04~0.69,P=0.01;高分化OR=0.06,95%CI为0.00~0.78,P=0.03。结论术前Cyfra21-1水平在肠癌患者中具有较高的阳性率,可能对判断肿瘤细胞分化程度、肿瘤侵犯范围等提供一定帮助。OBJECTIVE Cyfra21-1 is one of the conventional tumor markers but its role in colorectal cancer are still largely unknown. The present study aimed to investigate the correlation between the value of preoperative Cyfra21-1 and the clinicopathological parameters in colorectal cancer patients. METHODS Totally 115 pathologically confirmed valida- ted cases from June 1, 2012 to 2016 were collected in our hospital, parameters including gender, age, tumor location, cancer cell differentiation, TNM stage, microsatellite state, Ki-67 index, risk factors and the value of Cyfra21-1, CEA were recorded and further statistical analysis were performed. RESULTS Positive rate of preoperative Cyfra21-1 and CEA was 38.26%（44/115） and 37.39% （43/115）, respectively. Double positive and only Cyfra21-1 positive rate was 19.13%（22/115）, sole CEA positive rate was 18.26% （21/115）, whereas double negative rate was 43.47%%（50/115）. Value of preoperative Cyfra21-1 presented significant statistical differences in different cancer cell differentiation （χ^2 = 14.47, P〈0.001） and M stage （χ^2= 4.62, P = 0.03）, and preoperative CEA value shown similar diferenees in different T （χ^2 = 17.72, P= 0.00）, M （χ^2= 7.81,P= 0.00） and TNM stages （χ^2= 19.26,P〈0. 001）, both the max tumor diameter and number of positive lymph nodes were obviously elevated in Cyfra21-1 and CEA increased patients （all P〈0.05）. Cancer cell differentiation was found to be the most significant factors that could affect Cyfra 21-1 by Logistic regression analysis （with respect to low differentiation, moderate OR： 0. 17, 95% CI： 0. 04- 0. 69, P = 0. 01; high OR： 0. 06, 95%CI：0.00-0.78,P=0.03）. CONCLUSION Preoperative Cyfra21-1 has a relatively high positive rate in colorectal cancer patients and it would he helpful in estimating cancer cell differentiation and invasive range.

关 键 词：结直肠癌 肿瘤标志物 CYFRA21-1 癌胚抗原 细胞分化 

分 类 号：R735.3[医药卫生—肿瘤]