消化道肿瘤标记物CEA和CA-199比值对结直肠癌预后的影响  

Effect of CEA and CA-199 Ratio as Gastrointestinal Tumor Markers on the Prognosis of Colorectal Cancer

作　　者：侯华芳[1] 夏艳秋[1] 张哲 雷枭[2] HOU Huafang;XIA Yanqiu;ZHANG Zhe;LEI Xiao(The Second Department of Gastrointestinal Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Traditional Chinese Medicine,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院胃肠外二科,四川南充637000 [2]川北医学院附属医院中医科,四川南充637000

出　　处：《医学信息》2025年第8期70-74,共5页Journal of Medical Information

基　　金：四川省南充市市校合作科技战略合作专项(编号:19SXHZ0386);四川省医学会伤口疾病(泰阁)专项科研课题(编号:2021TG59)。

摘　　要：目的 研究CEA及CA-199表达正常的结直肠癌患者的其比值(EAR)对结直肠癌患者预后的影响及预测价值。方法 回顾性分析2014年1月-2016年6月于川北医学院附属医院经外科手术治疗且CEA及CA-199表达正常的129例结直肠癌患者的临床资料,分析其术前外周血EAR水平与结直肠癌临床病例特征的关系及其对预后的影响。结果 ROC曲线下面积(AUC)为0.7588,提示EAR具有诊断意义;ROC曲线截断值为0.5524。EAR的高低与淋巴结转移(P=0.027)及肿瘤大小(P=0.016)有关;生存分析显示,低EAR组总体生存率低于高EAR组(P=0.006);单因素COX分析结果提示,淋巴结转移(P=0.011)、肿瘤远处转移(P=0.001)及EAR表达情况(P=0.010)是结直肠癌患者的预后影响因素;多因素COX回归分析显示,肿瘤远处转移(P=0.017)及EAR表达情况(P=0.036)是影响结直肠癌患者预后的独立预后因素。结论 术前EAR可以作为CEA及CA-199表达正常的结肠癌患者预后的参考指标。Objective To study the effect of CEA/CA-199(EAR) on the prognosis of colorectal cancer patients with normal CEA and CA-199expression.Methods The clinical data of 129 colorectal cancer patients with normal CEA and CA-199 expression treated surgically in the Affiliated Hospital of North Sichuan Medical College from January 2014 to June 2016 were analyzed retrospectively.The relationship between preoperative peripheral blood EAR level and clinical case characteristics of colorectal cancer and its impact on prognosis were analyzed.Results The area under the ROC curve(AUC) was 0.7588,suggesting that EAR had diagnostic significance.The cutoff value of ROC curve was 0.5524.The level of EAR was related to lymph node metastasis(P=0.027) and tumor size(P=0.016).Survival analysis showed that the overall survival rate of the low EAR group was lower than that of the high EAR group(P=0.006).Univariate COX analysis showed that lymph node metastasis(P=0.011),distant metastasis(P=0.001)and EAR expression(P=0.010) were prognostic factors in patients with colorectal cancer.Multivariate COX regression analysis showed that distant metastasis(P=0.017) and EAR expression(P=0.036) were independent prognostic factors affecting the prognosis of patients with colorectal cancer.Conclusion Preoperative EAR can be used as a reference index for the prognosis of colon cancer patients with normal CEA and CA-199 expression.

关 键 词：结直肠癌 CEA/CA-199 预后 

分 类 号：R735.35[医药卫生—肿瘤]