摘要
目的探讨癌胚抗原(CEA)、糖类抗原(CA)19-9及CA72-4血清肿瘤标志物对胃癌患者术后复发转移的预测价值及影响因素分析。方法检测170例胃癌患者的血清CEA、CA19-9、CA72-4水平;采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评估CEA、CA19-9、CA72-4对胃癌患者术后复发转移的预测价值;胃癌患者术后复发转移的危险因素采用多因素Logistic回归分析。结果不同TNM分期胃癌患者血清CEA、CA19-9、CA72-4水平比较,差异均有统计学意义(P﹤0.01),胃癌患者的TNM分期越晚,血清CEA、CA19-9、CA72-4水平越高,差异均有统计学意义(P﹤0.05)。ROC曲线显示,CEA、CA19-9、CA72-4水平预测胃癌患者术后复发转移的AUC分别为0.830、0.683、0.725,cut-off值分别为51.62μg/L、69.38 U/ml、26.67 U/ml。截至随访终点,170例胃癌患者中,复发转移75例,未复发转移95例,复发转移率为44.12%,依据复发转移情况,将所有胃癌患者分为复发转移组(n=75)和未复发转移组(n=95),复发转移组和未复发转移组患者年龄、肿瘤大小、TNM分期、浸润深度、脉管癌栓、术后辅助治疗情况、CEA水平、CA19-9水平、CA72-4水平比较,差异均有统计学意义(P﹤0.05)。Logistic回归分析结果显示,浸润深度达浆膜层、TNM分期为Ⅲ~Ⅳ期、合并脉管癌栓、未接受术后辅助治疗、CEA≥51.62μg/L、CA19-9≥69.38 U/ml、CA72-4≥26.67 U/ml均是胃癌患者术后复发转移的独立危险因素(P﹤0.05)。结论CEA、CA19-9、CA72-4水平与肿瘤细胞浸润转移有关,可用于临床预测胃癌患者术后复发转移情况,筛选高危人群。
Objective To explore the predictive value and influencing factors of serum tumor markers such as carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9 and CA72-4 in patients with gastric cancer after recurrence and metastasis.Method Serum CEA,CA19-9 and CA72-4 were detected in 170 patients with gastric cancer;the predictive value of CEA,CA19-9 and CA72-4 in postoperative recurrence and metastasis of gastric cancer was evaluated by receiver operating characteristic(ROC)curve and area under the curve(AUC);the risk factors of postoperative recurrence and metastasis of gastric cancer patients were analyzed by multivariate Logistic regression.Result Comparison of serum CEA,CA19-9 and CA72-4 levels in patients with different TNM stages of gastric cancer,the difference was statistically significant(P<0.01).The serum CEA,CA19-9 and CA72-4 were higher for patients with late TNM stage of gastric cancer patients(P<0.05).The ROC curve showed that the AUC of CEA,CA19-9 and CA72-4 levels predicting postoperative recurrence and metastasis of gastric cancer patients were 0.830,0.683,0.725,and the cut-off values were 51.62μg/L,69.38 U/ml,26.67 U/ml.By the end of the follow-up,among 170 patients with gastric cancer,75 had recurrence and metastasis,95 had no recurrence and metastasis,and the recurrence and metastasis rate was 44.12%.According to recurrence and metastasis,all patients were divided into recurrence and metastasis group(n=75)and non-recurrence and metastasis group(n=95).There were significant differences in age,tumor size,TNM stage,invasion depth,vascular cancer thrombus,postoperative adjuvant treatment,CEA level,CA19-9 level and CA72-4 level between the two groups(P<0.05).Logistic regression analysis showed that the depth of infiltration reached the serosal layer,III-IV stage of TNM,vascular cancer thrombus,untreated postoperative adjuvant therapy,CEA≥51.62μg/L,CA19-9≥69.38 U/ml,and CA72-4≥26.67 U/ml were all independent risk factors for postoperative recurrence and metastasis of gastric cancer(P<0.05).Conclusion The levels of CEA,CA19-9 and CA72-4 are related to the invasion and metastasis of tumor cells,which can be used to predict the recurrence and metastasis of gastric cancer and screen high-risk population.
作者
董林
齐笛
何佳婧
李予南
DONG Lin;QI Di;HE Jiajing;LI Yu’nan(Department of Medical Laboratory,Sanmenxia Central Hospital,Sanmenxia 472000,He’nan,China)
出处
《癌症进展》
2021年第8期798-801,共4页
Oncology Progress
关键词
胃癌
癌胚抗原
糖类抗原
浸润深度
转移
gastric cancer
carcinoembryonic antigen
carbohydrate antigen
infiltration reached
metastasis
