糖类抗原199和癌胚抗原对直肠癌淋巴结转移的预测价值  

Predictive value of carbohydrate antigen 199 and carcinoembryonic antigen in lymph node metastasis of rectal cancer

作　　者：蔡焕锐 陈树钦 徐锡金 陈广灿[1,2] CAI Huanrui;CHEN Shuqin;XU Xijin;CHEN Guangcan(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Laboratory of Environmental Medicine and Developmental Toxicology,Shantou University Medical College,Shantou 515041,China;Department of Cell Biology and Genetics,Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院胃肠外科,广东汕头515041 [2]汕头大学医学院环境医学与发育毒理学实验室,广东汕头515041 [3]汕头大学医学院细胞生物学与遗传学教研室,广东汕头515041

出　　处：《汕头大学医学院学报》2020年第3期152-155,共4页Journal of Shantou University Medical College

基　　金：国家自然科学基金(41368005)。

摘　　要：目的:探讨糖类抗原199(CA199)和癌胚抗原(CEA)对直肠癌患者淋巴结转移的预测价值。方法:收集2015年5月—2019年10月于汕头大学医学院第一附属医院手术治疗的直肠癌患者163例,年龄24~87岁,平均(62.37±11.13)岁,其中男性88例,女性75例。所有患者术前均抽取肘正中静脉血2 m L,检测肿瘤标记物CA199和CEA。采用受试者工作特征(ROC)曲线分析血清CA199和CEA对直肠癌淋巴结转移的预测价值。手术切除的直肠癌标本均进行病理组织切片检验。结果:淋巴结转移组肿瘤浸润深度与无淋巴结转移组的差异具有统计学意义(P=0.028)。血清CA199、CEA单独与联合检测预测淋巴结转移的ROC曲线下面积分别为0.605(95%CI:0.512~0.699,P=0.026)、0.513(95%CI:0.417~0.609,P=0.780)和0.579(95%CI:0.485~0.672,P=0.096)。CA199的最佳临界值为20.495 U/mL,预测淋巴结转移的敏感度为49.2%,特异度为78.8%。结论:直肠癌患者淋巴结转移与肿瘤浸润深度有关,患者血清CA199水平>20.495 U/mL时,应警惕淋巴结转移的可能。Objective:To investigate the predictive value of carbohydrate antigen 199(CA199)and carcinoembryonic antigen(CEA)in lymph node metastasis of rectal cancer.Methods:From May 2015 to October2019,163 patients with rectal cancer,aged from 24 to 87 years,with an average of(62.37±11.13)years,were selected from the First Affiliated Hospital of Shantou University Medical College,including 88 males and 75 females.Before the operation,2 mL of blood from the median cubital vein was drawn from all patients,and the tumor markers CA199 and CEA were detected.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum CA199 and CEA for lymph node metastasis of rectal cancer.All rectal cancer specimens resected by surgery were examined by pathological tissue biopsy.Results:The difference between the depth of tumor invasion in the lymph node metastasis group and the non-lymph node metastasis group was statistically significant(P=0.028).The area under the ROC curve of serum CA199 and CEA alone and in combination to predict lymph node metastasis were 0.605(95%CI:0.512-0.699,P=0.026),0.513(95%CI:0.417-0.609,P=0.780)and 0.579(95%CI:0.485-0.672,P=0.096).The optimal cut-off value of CA199 is 20.495 U/mL,the sensitivity of predicting lymph node metastasis is 49.2%,and the specificity is 78.8%.Conclusion:Lymph node metastasis in patients with rectal cancer is related to the depth of tumor invasion.When the serum CA199 level of patients is greater than 20.495 U/mL,the possibility of lymph node metastasis should be vigilant.

关 键 词：直肠癌 CA199 CEA 淋巴结转移 

分 类 号：R735.37[医药卫生—肿瘤]