青年结直肠癌患者伴同时性腹膜转移的预测指标分析  

Analysis of predictors of concurrent peritoneal metastasis in youngpatients with colorectal cancer

作　　者：刘超[1] 李雷[1] 麦威[1] LIU Chao;LI Lei;MAI Wei(Department of Gastrointestinal,Hernia,and Intestinal Fistula Surgery,Guangxi Academy of Medical Sciences/The People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530021,China)

机构地区：[1]广西医学科学院/广西壮族自治区人民医院胃肠·疝·肠瘘外科,南宁530021

出　　处：《重庆医学》2023年第18期2801-2804,共4页Chongqing medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题项目(Z20180763)。

摘　　要：目的 探讨青年结直肠癌患者伴同时性腹膜转移的预测指标。方法 回顾性分析该院2017年1月至2022年1月确诊为结直肠癌的228例青年患者的病例资料,其中伴同时性腹膜转移32例(转移组),不伴同时性腹膜转移196例(对照组)。比较两组患者的术前中性粒细胞与淋巴细胞比(NLR)、血小板与淋巴细胞比(PLR)、血浆纤维蛋白原(FIB)、癌胚抗原(CEA)、血清糖类抗原19-9(CA19-9)、血清糖类抗原125(CA125)水平,以及肠镜病理类型等指标。采用logistic回归分析影响因素,受试者工作特征(ROC)曲线评估各指标对疾病的诊断价值。结果 转移组和对照组在术前体重减轻、肿瘤大小,CA125、CA19-9、FIB水平、肠镜病理类型等方面比较,差异有统计学意义(P<0.05)。logistic回归分析显示,术前体重减轻、肿瘤大小≥9.50 cm、CA125≥15.88 U/mL、CA19-9≥70.12μ/mL、FIB≥3.79 g/L与青年结直肠癌患者伴同时性腹膜转移相关(P<0.05)。CA125、CA19-9、FIB的ROC曲线下面积(AUC)分别为0.805、0.781、0.744,其对青年结直肠癌患者伴同时性腹膜转移有较好的预测价值。结论 青年结直肠癌患者术前出现体重减轻、CA125≥15.88 U/mL、CA19-9≥70.12μ/mL、FIB≥3.79 g/L时,警惕伴有腹膜转移。Objective To explore the indicators for predicting concurrent peritoneal metastasis in young patients with colorectal cancer.Methods Data of 228 young patients who were diagnosed with colorectal cancer in this hospital from January 2017 to January 2022 were retrospectively analyzed,including 32 patients with concurrent peritoneal metastasis(the metastasis group)and 196 patients without(the control group).The preoperative neutrophil to lymphocyte ratio(NLR),preoperative platelet to lymphocyte ratio(PLR),preoperative plasma fibrinogen(FIB),preoperative carcinoembryonic antigen(CEA),preoperative serum carbohydrate antigen 19-9(CA19-9),preoperative serum carbohydrate antigen 125(CA125),preoperative colonoscopic pathological type and other indicators were compared between the two groups.Logistic regression was used to analyze the influencing factors,the receiver operating characteristic curve(ROC)was used to assess the diagnostic value of each indicator for the disease.Results There were significant differences in preoperative weight loss,tumor size,CA125,CA19-9,FIB and preoperative colonoscopic pathological type between the metastasis group and the control group(P<0.05).Logistic regression analysis showed that preoperative weight loss,tumor size≥9.50 cm,CA125≥15.88 U/mL,CA19-9≥70.12μ/mL,FIB≥3.79 g/L were associated with concurrent peritoneal metastasis in young colorectal cancer patients(P<0.05).The area under ROC curve(AUC)of CA125,CA19-9 and FIB were 0.805,0.781 and 0.744,respectively,which had good predictive value for colorectal cancer with concurrent peritoneal metastasis.Conclusion When weight loss,CA125≥15.88 U/mL,CA19-9≥70.12μ/mL,FIB≥3.79 g/L occur in young patients with colorectal cancer before surgery,it is necessary to be alert to the presence of peritoneal metastasis.

关 键 词：青年 结直肠癌 腹膜转移 

分 类 号：R446.1[医药卫生—诊断学]