多层螺旋CT参数、癌胚抗原、错配修复基因及病理指标对结直肠癌预后的影响  

Effects of multi-slice spiral CT parameters,carcinoembryonic antigen,mismatch repair gene,and pathological indicators on prognosis of colorectal cancer

作　　者：陈倩倩 袁晨 刘基[1] 尹婷婷[1] Chen Qianqian;Yuan Chen;Liu Ji;Yin Tingting(Department of Radiology,Huainan Oriental Hospital Group General Hospital,Huainan 232000,China;Department of Radiology,Guangji Hospital,Huainan Oriental Hospital,Huainan 232000,China)

机构地区：[1]淮南东方医院集团总院影像科,安徽省232000 [2]淮南东方医院广济医院影像科,安徽省232000

出　　处：《中华消化病与影像杂志（电子版）》2024年第6期507-511,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的分析结直肠癌患者多层螺旋CT与癌胚抗原(CEA)、错配修复(MMR)基因蛋白表达水平及病理指标和预后的关联。方法纳入淮南东方医院集团总院2019年1月至2021年9月收治的100例结直肠癌患者,按照其3年存活情况,将患者分别纳入存活组、死亡组,整理并比较2组患者治疗前多层螺旋CT特征、CEA水平,以及术中切除病理组织MMR蛋白检测结果的差异,使用Logistic多因素回归分析,归纳影响结直肠癌患者预后的相关因素。结果100例患者均获得有效随访,中位随访时间69个月。随访3年时31例患者死亡、69例患者存活,患者3年死亡率为31.00%。Logistic多因素回归分析示,平扫CT值≤40 HU、增强扫描CT值≤75 HU、周围脂肪密度增高、血管增粗、肿瘤强化不均匀、淋巴结转移、CEA≥13.50μg/L、肿瘤直径≥5 cm、TNM分期Ⅲ期、中低分化均为影响结直肠癌3年生存率的独立危险因素,MMR蛋白表达缺失为保护性因素(P<0.05)。结论结直肠癌患者预后与多层螺旋CT特征、CEA、病理指标密切相关,且MMR蛋白缺失可能与患者更高的3年生存率有关。Objective To analyze the correlation between multi-slice spiral CT,carcinoembryonic antigen(CEA),mismatch repair gene(MMR)protein level,pathological indicators and prognosis in patients with colorectal cancer.Methods A total of 100 patients with colorectal cancer admitted to Huainan Oriental Hospital Group General Hospital from January 2019 to September 2021 were included.According to their 3-year survival,the patients were divided into survival group and death group.The differences in multi-slice spiral CT characteristics,CEA levels,and MMR protein detection results of the pathological tissues removed during operation between the two groups were sorted out and compared.Logistic multivariate regression analysis was used to summarize the related factors affecting the prognosis of patients with colorectal cancer.Results All 100 patients were effectively followed up,with a median follow-up time of 69 months.At the end of 3-year follow-up,31 patients died and 69 patients survived,with a 3-year mortality rate of 31.00%.Logistic multivariate regression analysis showed that the plain scan CT value≤40 HU,enhanced scan CT value≤75 HU,increased peripheral fat density,thickened blood vessels,uneven tumor enhancement,lymph node metastasis,CEA≥13.50μg/L,tumor diameter≥5 cm,TNM stageⅢ,and moderate to poor differentiation were independent risk factors affecting the 3-year survival rate of colorectal cancer,and the loss of MMR protein expression was a protective factor(P<0.05).Conclusion The prognosis of colorectal cancer patients is closely related to the characteristics of multi-slice spiral CT,CEA and pathological indexes,and the loss of MMR protein may be associated with a higher 3-year survival rate.

关 键 词：结直肠癌 体层摄影术 X线计算机 癌胚抗原 错配修复基因 病理 预后 

分 类 号：R735.34[医药卫生—肿瘤]