基于结直肠癌区域淋巴结转移、病理分期和原发位置的肿瘤标志物差异分析  

A Differential Analysis of Tumor Markers Based on Regional Lymph Node Metastasis,Pathological Staging and Primary Location in Colorectal Cancer

作　　者：王璐鹏 孟倩 张曼 WANG Lupeng;MENG Qian;ZHANG Man(Department of Medical Laboratory,Beijing Shijitan Hospital Affiliated to CapitalMedical University,Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院医学检验科尿液细胞分子诊断北京市重点实验室,北京100038

出　　处：《标记免疫分析与临床》2024年第10期1794-1799,共6页Labeled Immunoassays and Clinical Medicine

基　　金：首都医科大学附属北京世纪坛医院“十四五”领军人才培养项目(编号:2023LJRCZM)。

摘　　要：目的探讨血清肿瘤标志物指标在结直肠癌(colorectal cancer,CRC)区域淋巴结转移、病理分期和肿瘤原发位置中的差异变化,为结直肠癌的诊断与治疗提供依据。方法纳入155例结直肠癌患者为疾病组(CRC组),根据肿瘤区域淋巴结转移情况、病理分期(pStage)、原发肿瘤位置的不同分别将CRC患者分为N_(0)组和N_(1+2)组、I+II组和III+IV组、结肠组(colon)和直肠组(rectum)。同期纳入156例健康体检受试者作为正常对照组(normal control,NC),收集受试者的临床资料、肿瘤标志物等检验结果。分析各组间血清肿瘤标志物等实验室检测结果的差异。通过ROC曲线评价相关检测指标对CRC的区域淋巴结转移情况和病理分期的诊断价值。结果结直肠癌组的CEA、CA19-9、CA125水平较对照组显著升高(均P<0.05),而CA72-4、AFP水平变化差异无统计学意义(均P>0.05)。CEA水平在NC组、N_(0)组和N_(1+2)组中比较差异具有统计学意义(N_(0)组>NC组,N_(1+2)组>NC组,N_(1+2)组>N_(0)组,均P<0.05),CA19-9、CA125、CA72-4、AFP差异未见统计学意义(均P>0.05)。在肿瘤分期方面,CEA水平在NC组、I+II组和III+IV组比较中差异具有统计学意义(I+II组>NC组,III+IV组>NC组,III+IV组>I+II组,均P<0.05),其余指标差异未见统计学意义。在肿瘤原发位置方面,结肠癌组和直肠癌组患者的CEA、CA19-9、CA125水平显著高于正常人组(P<0.05),CA72-4、AFP水平较正常人组差异无统计学意义(P>0.05),结肠癌组与直肠癌组之间的CEA、CA19-9、CA125、CA15-3、CA72-4、AFP水平差异无统计学意义(均P>0.05)。在区域淋巴结转移的进展评估中,CEA的AUC(95%CI)为0.664(0.578~0.750),灵敏度和特异性分别为0.704和0.595;在区分肿瘤分期方面,CEA的AUC(95%CI)为0.696(0.613~0.779),灵敏度和特异性分别为0.711和0.620。结论血清CEA检测水平对于评估CRC的淋巴结转移和病理分期具有一定的临床价值。Objective To investigate the differential changes of serum tumor marker indexes in regional lymph node metastasis,pathological staging and tumor primary location of colorectal cancer(CRC),and to provide a reference basis for the diagnosis and treatment of colorectal cancer.Methods 155 colorectal cancer patients were included as the disease group(CRC group),and the CRC patients were further divided into N_(0)and N_(1+2)groups,I+II and III+IV groups,colon(colon)and rectum(rectum)groups according to the differences in tumor regional lymph node metastasis,pathological stage(pStage),and locations of the primary tumor,respectively.During the same period,156 healthy physical examination subjects were included as the normal control(NC)group.The clinical data,tumor markers and other related test results of these subjects were collected for the analysis.Differences in laboratory test results,such as serum tumor markers,were analyzed among the groups.The diagnostic value of the relevant testing indexes on the regional lymph node metastasis and pathological staging of CRC was evaluated by ROC curve.Results The levels of CEA,CA19-9 and CA125 in the colorectal cancer group were significantly higher than those in the control group(all P<0.05),while the differences in the levels of CA72-4 and AFP were not statistically significant(all P>0.05).The differences in the levels of CEA were statistically significant when comparing the levels of the NC group,the N_(0)group and the N_(1+2)group(N_(0)>NC,N_(1+2)>NC,N_(1+2)>NC,N_(1+2)>N_(0),all P<0.05),and no statistically significant differences were observed in CA19-9,CA125,CA72-4,and AFP(all P>0.05).In terms of tumor staging,the difference in CEA level was statistically significant for the comparison of NC,I+II and III+IV groups(I+II>NC,III+IV>NC,III+IV>I+II,all P<0.05),and no statistically significant difference was seen among the rest of the indicators.In terms of tumor primary location,the levels of CEA,CA19-9 and CA125 were significantly higher in patients in the colon cancer group

关 键 词：结直肠癌 肿瘤标志物 癌胚抗原 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]