术前血清CEA、CA153、CA724及CA199水平与直肠癌临床分期及预后的关系  

The Relationship Between Preoperative Combined Detection of Serum CEA,CA153,CA724,and CA199 Levels and Clinical Staging and Prognosis of Rectal Cancer

作　　者：梁硕[1] 黄诚[1] 简雪峰[1] LIANG Shuo;HUANG Cheng;JIAN Xuefeng(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471003)

机构地区：[1]河南科技大学第一附属医院,471003

出　　处：《实用癌症杂志》2024年第9期1393-1397,共5页The Practical Journal of Cancer

基　　金：国家自然科学基金项目(编号:81872500)。

摘　　要：目的探讨术前血清癌胚抗原(CEA)、糖类抗原153(CA153)、糖类抗原724(CA724)及糖类抗原199(CA199)水平与直肠癌临床分期及预后的关系。方法随机选取196例直肠癌患者为研究对象,比较不同分期及不同预后患者术前血清CEA、CA153、CA724和CA199水平。采用多因素Logistic回归分析直肠癌患者预后不良的影响因素;采用受试者工作特征(ROC)曲线分析术前血清CEA、CA153、CA724及CA199水平对直肠癌患者预后的预测价值。结果Ⅰ~Ⅳ期直肠癌患者术前血清CEA、CA153、CA724及CA199水平差异具有统计学意义(P<0.05),且随着分期的增加呈现上升趋势。预后不良组和预后良好组在淋巴结转移、分化程度、浸润深度及肿瘤直径方面比较差异具有统计学意义(P<0.05);与预后良好组比较,预后不良组术前血清CEA、CA153、CA724及CA199水平均明显较高(P<0.05);多因素Logistic回归分析结果显示,直肠癌患者血清CEA、CA153、CA724、CA199、淋巴结转移、低分化程度、浸润深度(T3~T4)为预后不良的独立危险因素(P<0.05)。ROC结果显示,血清CEA、CA153、CA724及CA199水平单独预测直肠癌患者预后的AUC分别为0.825、0.803、0.793、0.766,灵敏度分别为73.08%、67.31%、69.23%、71.15%,特异度分别为85.61%、84.89%、86.33%、87.05%;血清CEA、CA153、CA724及CA199水平联合预测直肠癌患者预后的AUC为0.883(95%CI:0.828~0.925),显著大于血清CEA单独预测的AUC(Z=2.134,P=0.033)、CA153单独预测的AUC(Z=2.167,P=0.030)、CA724单独预测的AUC(Z=2.288,P=0.022)和CA199单独预测的AUC(Z=2.801,P=0.005)。结论直肠癌患者术前血清CEA、CA153、CA724和CA199水平与临床分期和预后有关,且四者联合检测对患者预后具有较高的预测价值。Objective To investigate the relationship between the levels of carcinoembryonic antigen(CEA),carbohydrate antigen 153(CA153),carbohydrate antigen 724(CA724)and carbohydrate antigen 199(CA199)before operation and the clinical stage and prognosis of rectal cancer.Methods 196 patients with rectal cancer were randomly selected as the study objects,and the preoperative serum CEA,CA153,CA724 and CA199 levels were compared in patients with different stages and different prognosis.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients with rectal cancer.The predictive value of preoperative serum CEA,CA153,CA724 and CA199 levels in patients with rectal cancer was analyzed by receiver operating characteristic(ROC)curve.Results There were statistically obvious differences in preoperative serum levels of CEA,CA153,CA724,and CA199 among patients with stageⅠ~Ⅳrectal cancer(P<0.05),and with the increase of stages,there was an upward trend;the difference in lymph node metastasis,degree of differentiation,depth of infiltration,and tumor diameter between the poor prognosis group and the good prognosis group was statistically obvious(P<0.05);compared with the good prognosis group,the poor prognosis group had obviously higher levels of preoperative serum CEA,CA153,CA724,[LM]and CA199(P<0.05);the results of multivariate Logistic regression analysis showed that serum CEA,CA153,CA724,CA199,lymph node metastasis,low differentiation,and depth of infiltration(T3~T4)were independent risk factors for poor prognosis in rectal cancer patients(P<0.05).The ROC results showed that the AUC of serum CEA,CA153,CA724,and CA199 levels alone in predicting the prognosis of rectal cancer patients was 0.825,0.803,0.793,and 0.766,respectively,with sensitivity of 73.08%,67.31%,69.23%,and 71.15%,and specificity of 85.61%,84.89%,86.33%,and 87.05%,respectively;the AUC of combined prediction of serum CEA,CA153,CA724,and CA199 levels for the prognosis of rectal cancer patients was 0.883(95%CI:0.828~0.925)

关 键 词：直肠癌 癌胚抗原 糖类抗原153 糖类抗原724 糖类抗原199 预后 

分 类 号：R735.37[医药卫生—肿瘤]