癌胚抗原和空腹血糖与结直肠癌患者预后的相关性研究  

The impact of carcinoembryonic antigen and fasting plasma glucose on the prognosis of colorectal cancer

作　　者：陈秀清[1,2] 杨立勇 沈喜妹[1,2] 刘东晖 吴佩文[1,2] CHEN Xiu-qing;YANG Li-yong;SHEN Xi-mei;LIU Dong-hui;WU Pei-wen(Department of Endocrinology,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,Fujian Province,China;Diabetes Research Institute of Fujian Province,Fuzhou 350005,Fujian Province,China)

机构地区：[1]福建医科大学附属第一医院内分泌科,福建福州350005 [2]福建省糖尿病防治研究院,福建福州350005

出　　处：《中国临床药理学杂志》2020年第12期1621-1624,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的研究手术前癌胚抗原(CEA)和空腹血糖(FPG)与结直肠癌远期预后的关系。方法回顾性分析2008年6月到2011年9月在我院经过根治性手术的高危Ⅱ期和Ⅲ期结直肠癌患者246例,应用R软件选取预测预后的CEA和FPG的最佳截点值,SPSS19.0软件比较术后转移复发组和无转移复发组的一般资料及CEA、FPG差异,Kaplan-Meier法比较不同水平CEA和FPG组患者的生存曲线,COX比例风险回归模型,分析CEA、FPG与无病生存期(DFS)的相关性。结果平均随访时间74(6~114)个月。在预测DFS中,CEA的最佳截点值为2.95 ng·mL^-1,FPG的最佳截点值为5.83 mmol·L^-1。转移复发组高CEA(≥2.95 mmol·L^-1)及高FPG(≥5.83 mmol·L^-1)的比例大于无转移复发组,差异有统计学意义(P<0.05)。高CEA-高FPG组(CEA≥2.95 ng·mL^-1并且FPG≥5.83 mmol·L^-1)预后最差,5年DFS为57.50%,正常CEA-正常FPG组(CEA<2.95 ng·mL^-1并且FPG<5.83 mmol·L^-1)预后最好,5年DFS为83.10%,2组差异有统计学意义(P<0.05)。COX比例风险回归模型显示,术前CEA及FPG升高是结直肠癌术后转移复发的独立危险因素(均P<0.05)。结论联合检测CEA和FPG有助于预测高危Ⅱ期和Ⅲ期结直肠癌患者的远期预后。Objective To investigate the impact of carcinoembryonic antigen(CEA)and fasting plasma glucose(FPG)on the prognosis of colorectal cancer(CRC)patients.Methods A total of 246 patients with high-risk stageⅡand stageⅢcolorectal cancer who underwent radical surgery in our hospital were analyzed retrospectively from June 2008 to September 2011.The cut-off values of CEA and FPG were determined via the R software to classify patients into the poor and good prognosis subgroup,and their prognostic values were assessed using Kaplan-Meier curve and Cox regression models.Results The follow-up time was 74(6-114)months.The cut-off values of CEA and FPG were 2.95 ng·mL^-1 and 5.83 mmol·L^-1 in predicting prognosis.The proportion of high CEA(≥2.95 ng·mL^-1)in the metastasis and recurrence group(68.49%)was significantly higher than that in the non-metastasis and non-recurrence group(53.76%).The proportion of high FPG(≥5.83 mmol·L^-1)in the metastasis and recurrence group(32.88%)was significantly higher than that in the non-metastasis and non-recurrence group(20.81%).The 5-year disease-free survival(DFS)of high CEA-high FPG group(CEA≥2.95 ng·mL^-1 and FPG≥5.83 mmol·L^-1)was 57.5%,while 5-year DFS of normal CEA-normal FPG group(CEA<2.95 ng·mL^-1 and FPG<5.83 mmol·L^-1)was 83.10%,the difference was statistically significant(P<0.05).Cox proportional risk regression model showed that the increased CEA and FPG were independent risk factors for metastasis and recurrence of colorectal cancer(P<0.05).Conclusion The combined detection of CEA and FPG can predict the long-term prognosis of patients with high-risk stageⅡand stageⅢcolorectal cancer.

关 键 词：癌胚抗原 空腹血糖 结直肠癌 预后 

分 类 号：R979.1[医药卫生—药品]