CA242围手术期变化模式及纵向轨迹与结直肠癌预后的关联:一项回顾性纵向队列研究  

Perioperative changing patterns and longitudinal trajectories of CA242 with colorectal cancer prognosis:a retrospective longitudinal cohort study

作　　者：李春霞 游瑞敏 刘丽珠 李艳丽 蒲宏江 雷鸣 李振辉 游顶云 熊秋霞 张涛 Chunxia Li;Ruimin You;Lizhu Liu;Yanli Li;Hongjiang Pu;Ming Lei;Zhenhui Li;Dingyun You;Qiuxia Xiong;Tao Zhang(Department of Biostatistics,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Institute for Medical Dataology,Shandong University,Jinan 250002,China;Department of Radiology,the Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Yunnan Cancer Center,Kunming 650118,China;Department of Colorectal Surgery,the Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Yunnan Cancer Center,Kunming 650118,China;Department of Clinical Laboratory Medicine,the Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Yunnan Cancer Center,Kunming 650118,China;School of Biomedical Engineering Research,Kunming Medical University,Kunming 650500,China;Yunnan Key Laboratory of Laboratory Medicine,Kunming 650032,China;Yunnan Province Clinical Research Center for Laboratory Medicine,Kunming 650032,China;Department of Clinical Laboratory,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]Department of Biostatistics,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China [2]Institute for Medical Dataology,Shandong University,Jinan 250002,China [3]Department of Radiology,the Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Yunnan Cancer Center,Kunming 650118,China [4]Department of Colorectal Surgery,the Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Yunnan Cancer Center,Kunming 650118,China [5]Department of Clinical Laboratory Medicine,the Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Yunnan Cancer Center,Kunming 650118,China [6]School of Biomedical Engineering Research,Kunming Medical University,Kunming 650500,China [7]Yunnan Key Laboratory of Laboratory Medicine,Kunming 650032,China [8]Yunnan Province Clinical Research Center for Laboratory Medicine,Kunming 650032,China [9]Department of Clinical Laboratory,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China

出　　处：《Science Bulletin》2023年第17期1875-1879,共5页科学通报（英文版）

基　　金：supported by the Yunnan Digitalization,Development and Application of Biotic Resource(202002AA100007);the National Natural Science Foundation of China(82222064,81973147,82001986,and 82073569);Shandong Medical and Health Technology Development Project(202005010068);Shandong University Distinguished Young Scholars;the Outstanding Youth Science Foundation of Yunnan Basic Research Project(202001AW070021,and 202101AW070001);the Reserve Talent Project for Young and Middle-Aged Academic and Technical Leaders(2012005AC160023);the Key Science Foundation of Yunnan Basic Research(202101AS070040);the Innovative Research Team of Yunnan Province(202005AE160002);the Science Foundation of Yunnan Basic Research(202201AT070010)。

摘　　要：以往关于CA242的研究大多局限于术前水平,忽略了其围手术期变化模式和纵向轨迹.基于一项结直肠癌(CRC)患者的回顾性队列,本研究根据术前和术后CA242水平确定了围手术期CA242变化模式,利用随访期间CA242的重复测量识别了CA242纵向轨迹,并评估了其与CRC预后的关系.结果显示,围手术期CA242变化模式是CRC的独立预后因素.术后CA242持续升高患者的无复发生存率(RFS)低于术后CA242恢复正常的患者,且术后/术前CA242比值可进一步对这两组患者进行复发风险分层.轨迹分析发现,术后3年内CA242存在低稳定、早期上升和晚期上升三种纵向变化模式.纵向轨迹与RFS显著相关,且独立于术前和术后CA242.在CEA正常的患者中,CA242的围手术期变化模式和纵向轨迹与RFS之间仍然存在显著关联,表明在CEA基础上测量CA242有助于识别预后较差的高危CRC患者.基于本研究结果,建议对CRC患者进行CA242的常规术后随访.

关 键 词：CA242 纵向变化 无复发生存率 围手术期 风险分层 重复测量 结直肠癌 轨迹分析 

分 类 号：R735.34[医药卫生—肿瘤]