铁蛋白联合癌胚抗原及病理指标对结肠癌预后的评估价值  

Study on ferritin combined with carcinoembryonic antigen and pathological parameters in prognostic evaluation of colon cancer

作　　者：黄明 江明凤[1] 林盛静 HUANG Ming;JIANG Ming-feng;LIN Sheng-jing(Department of Laboratory Medicine,Hangzhou Cancer Hospital,Hangzhou 310002,Zhejiang,China;不详)

机构地区：[1]杭州市肿瘤医院检验科,浙江杭州310002 [2]浙江大学医学院附属儿童医院实验检验中心,浙江杭州310002

出　　处：《广东医学》2022年第9期1145-1149,共5页Guangdong Medical Journal

基　　金：浙江省公益技术应用社会发展项目(LGF19H310001)。

摘　　要：目的 探讨血清铁蛋白联合癌胚抗原(CEA)及病理指标对结肠癌患者预后评估的意义。方法 以新发、未治疗的130例结肠癌患者为研究对象。检测患者治疗前血清铁蛋白和CEA水平,收集患者的临床病理数据。对所有患者进行随访,随访终点为全因死亡。结果 受试者工作特征(ROC)曲线结果显示,CEA和铁蛋白鉴别患者预后结局的曲线下面积(AUC)分别为0.77和0.66,敏感度最高为84.6%,特异度最高为85.7%。CEA、铁蛋白不同水平与结肠癌患者的合并症及临床病理特征无特定关系。Kaplan-Meier生存分析表明,CEA≤51.31 ng/mL组患者整体生存率显著高于CEA>51.31 ng/mL组(P<0.001);铁蛋白≤176.3 ng/mL组患者整体生存率显著高于铁蛋白>176.3 ng/mL组(P=0.002)。多因素Cox回归分析证实,TNM分期、脉管癌栓、CEA>51.31 ng/mL(HR=3.72,P<0.001)以及铁蛋白>176.3 ng/mL(HR=3.23,P=0.01)是影响结肠癌患者整体生存率的独立危险因素。CEA联合铁蛋白鉴别患者预后的AUC提升至0.80。结论 血清铁蛋白联合CEA检验及病理指标有助于结肠癌患者预后精准评估。Objective To investigate the significance of serum ferritin,carcinoembryonic antigen(CEA)and pathological parameters in the combined assessment of the prognosis in patients with colon cancer.Methods Data from a total of 130 de novo treatment-naive colon cancer patients from January 2014 to January 2018 were analyzed.Patients′serum ferritin and CEA were measured prior to the initiation of treatment.All patients were followed-up,with the primary end-point of all-cause mortality.Results The receiver-operating characteristic curve indicated that the CEA and ferritin distinguished patient outcomes with an area under the curve(AUC)of 0.77 and 0.66,respectively.The highest sensitivity and specificity was 84.6%and 85.7%,respectively.CEA and ferritin showed no significant correlations between patient co-morbidities nor clinicopathological features.The Kaplan-Meier survival analysis demonstrated that patients with CEA≤51.31 ng/mL had significantly higher overall survival than those with CEA>51.31 ng/mL(P<0.001).Similarly,patients with ferritin≤176.3 ng/mL had significantly more favorable overall survival than those with ferritin>176.3 ng/mL(P=0.002).Multivariate Cox regression analysis corroborated that the TNM classification,vascular tumor embolus,CEA>51.31 ng/mL(HR=3.72,P<0.001)and ferritin>176.3 ng/mL(HR=3.23,P=0.01)were independent risk factors for all-cause mortality in patients with colon cancer.The AUC to differentiate patient outcomes increased to 0.80 when CEA and ferritin were used in combination.Conclusion Measurement of ferritin combined with CEA and pathological parameters are helpful for the precise assessment of the outcomes in patients with colon cancer.

关 键 词：结肠癌 铁蛋白 癌胚抗原 预后 

分 类 号：R735.35[医药卫生—肿瘤] R446.1[医药卫生—临床医学]