直肠癌病人CD68^(+)TAMs水平及与CEA联合检测评估复发风险的价值  

Level of CD68^(+)TAMs in rectal cancer patients and value of its combination detection with CEA in evaluating the risk of recurrence

作　　者：孙振锐 何秀关 SUN Zhenrui;HE Xiuguan(Department of Emergency,General Hospital of Southern Theatre Command,Guangzhou Guangdong 510010,China)

机构地区：[1]中国人民解放军南部战区总医院急诊科,广东广州510010

出　　处：《蚌埠医科大学学报》2025年第3期359-363,共5页Journal of Bengbu Medical University

摘　　要：目的:探讨直肠癌根治术病人术前CD68^(+)肿瘤相关巨噬细胞(TAMs)水平及与癌胚抗原(CEA)联合检测评估复发风险的价值。方法:选取直肠癌根治术治疗病人150例,使用流式细胞术检测癌组织中CD68^(+)TAMs的表达水平,使用化学发光免疫分析法检测血清CEA水平。对所有病人进行至少1年随访,复发者纳入复发组,未复发者纳入未复发组。比较肿瘤组织和癌旁组织、复发组肿瘤组织与未复发组肿瘤组织中的CD68^(+)TAMs比例,并使用ROC曲线分析CD68^(+)TAMs比例和CEA水平联合评估直肠癌根治术病人术后复发风险的约登指数。结果:病人肿瘤组织中CD68^(+)TAMs比例为(21.58±3.98)%,高于癌旁正常组织中(8.32±1.06)%(P<0.01)。复发组病人肿瘤组织中CD68^(+)TAMs比例为(16.25±2.06)%,低于未复发组病人肿瘤组织中(26.85±3.51)%(P<0.01)。单因素分析发现,复发组与未复发组病人CA199、CEA、肿瘤组织CD68^(+)TAMs比例、病理分型方面差异均有统计学意义(P<0.05~P<0.01)。多因素回归分析显示,血清CEA、病理分型是直肠癌术后病人复发的危险因素(P<0.01和P<0.05),肿瘤组织CD68^(+)TAMs比例是直肠癌术后病人复发的保护因素(P<0.05)。ROC曲线分析显示,CD68^(+)TAMs比例与CEA水平联合检测的约登指数高于单独检测。结论:CD68^(+)TAMs细胞比例在直肠癌组织中较正常组织明显上升。直肠癌根治术后癌组织中CD68^(+)TAMs比例与术后复发相关,将该指标与术后血清CEA指标联合进行ROC曲线分析,对预测病人复发风险具有一定价值。对于术后癌组织CD68^(+)TAMs比例和血清CEA水平超过诊断阈值的病人,应警惕复发,可考虑术后强化化疗方案。Objective:To explore the value of preoperative CD68^(+)tumor-associated macrophages(TAMs)levels and its combination detection with carcinoembryonic antigen(CEA)in evaluating the risk of recurrence in patients undergoing radical resection of rectal cancer.Methods:A total of 150 patients with rectal cancer undergoing radical surgery were selected,the expression level of CD68^(+)TAMs in cancer tissue was detected using flow cytometry,and serum CEA levels were measured using chemiluminescence immunoassay.All patients were followed up for at least 1 year,who experienced recurrence were included in the recurrence group,and who did not experience recurrence were included in the non-recurrence group.The proportion of CD68^(+)TAMs in tumor tissue and adjacent cancer tissue,as well as in tumor tissue of the recurrence group and non-recurrence group were compared.The receiver operating characteristic(ROC)curve was used to analyze the combined evaluation of CD68^(+)TAMs proportion level and CEA level to evaluate the Jordan index of postoperative recurrence risk in rectal cancer patients undergoing radical surgery.Results:The proportion of CD68^(+)TAMs in tumor tissue of 150 patients was(21.58±3.98)%,while the proportion of CD68^(+)TAMs in normal tissue adjacent to cancer was(8.32±1.06)%,and the difference of which between the two groups was statistically significant(P<0.01).The proportion of CD68^(+)TAMs in tumor tissue of patients in the recurrence group was(16.25±2.06)%,while the proportion of CD68^(+)TAMs in tumor tissue of patients in the non-recurrence group was(26.85±3.51)%,and the difference of which between the two groups was statistically significant(P<0.01).Univariate analysis indicated that there were significant differences in CA199,CEA,proportion of CD68^(+)TAMs in tumor tissue,and pathological classification between the recurrence group and non-recurrence group(P<0.05 to P<0.01).Multivariate regression analysis showed that serum CEA and pathological classification were risk factors for postoperative recurre

关 键 词：直肠肿瘤 根治术 肿瘤相关巨噬细胞 癌胚抗原 复发 

分 类 号：R735.3[医药卫生—肿瘤]