摘要
目的探讨肿瘤体积变化、鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、糖类抗原125(CA125)与宫颈癌同步放化疗患者预后的关系及联合预测预后。方法选取2018年2月至2020年2月山西省肿瘤医院收治的128例行根治性同步放化疗宫颈癌患者进行前瞻性研究,根据预后效果不同分为预后不良组(44例)、预后良好组(84例)。比较两组一般资料、瘤体缩减率(TVRR)、SCC-Ag、CEA、CA125水平,采用Logistic回归方程分析宫颈癌同步放化疗患者预后相关影响因素,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析各指标及联合预测预后的效能,Kaplan-Meier生存曲线分析、log-rank(Mantel-Cox)检验TVRR、SCC-Ag、CEA、CA125高危者、低危者生存曲线。结果预后不良组TVRR低于预后良好组[(76.63±7.52)%比(85.54±6.71)%],SCC-Ag、CEA、CA125高于预后良好组[(6.98±2.15)μg/L比(4.61±1.37)μg/L、(9.34±2.23)μg/L比(5.76±1.87)μg/L、(68.79±12.01)kU/L比(49.97±15.22)kU/L](P<0.05);Logistic回归分析结果显示,TVRR、SCC-Ag、CEA、CA125是宫颈癌同步放化疗患者预后的显著影响因素(P<0.05);单一指标中,TVRR预测预后的AUC最大,各指标联合预测预后的AUC(0.837,95%CI 0.761~0.920)大于任一单一指标,灵敏度为81.82%,特异度为84.52%;TVRR、SCC-Ag、CEA、CA125高危与低危者生存曲线比较,差异均有统计学意义(P<0.05)。结论肿瘤体积变化、SCC-Ag、CEA、CA125与宫颈癌同步放化疗患者预后具有一定相关性,早期采用四者联合检查,有望成为临床预测宫颈癌预后、制定恰当治疗方案的新途径。
Objective To investigate the relationship between tumor volume changes,squamous cell carcinoma antigen(SCC-Ag),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and the prognosis of cervical cancer patients with concurrent radiotherapy and chemotherapy and their combined prediction of prognosis.Methods One hundred and twenty-eight patients in Shanxi Cancer Hospital from February 2018 to February 2020,with cervical cancer undergoing radical concurrent radiotherapy and chemotherapy were selected for a prospective study.According to different prognostic effects,the patients were divided into poor prognosis group(44 cases)and good prognosis group(84 cases).The general data,tumor reduction rate(TVRR),SCC-Ag,CEA,and CA125 levels were compared between the two groups,and the Logistic regression equation was used to analyze the prognostic factors of patients with concurrent radiotherapy and chemotherapy for cervical cancer.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to analyze the performance of each index and the joint prediction of prognosis.Kaplan-Meier survival curve analysis and log-rank(Mantel-Cox)were used to test the survival curves of TVRR,SCC-Ag,CEA,CA125 high-risk individuals and low-risk individuals.Results The TVRR in the poor prognosis group was significantly lower than that in the good prognosis group:(76.63±7.52)%vs.(85.54±6.71)%,the SCC-Ag,CEA,CA125 were significantly higher than those in the good prognosis group:(6.98±2.15)μg/L vs.(4.61±1.37)μg/L,(9.34±2.23)μg/L vs.(5.76±1.87)μg/L,(68.79±12.01)kU/L vs.(49.97±15.22)kU/L,and there were statistical differences(P<0.05).Logistic regression showed that TVRR,SCC-Ag,CEA and CA125 were significant factors influencing the prognosis of patients with concurrent chemoradiotherapy for cervical cancer(P<0.05).Among the single indicators,TVRR predicted the highest prognosis AUC,and the combined prognostic AUC of all indicators(0.837,95%CI 0.761 to 0.920)was higher than any single indicator,with a sens
作者
袁红琴
王霞
刘楷东
Yuan Hongqin;Wang Xia;Liu Kaidong(The First Ward of Abdominal and Pelvic Radiotherapy,Shanxi Cancer Hospital,Taiyuan 031000,China)
出处
《中国医师进修杂志》
2022年第5期385-392,共8页
Chinese Journal of Postgraduates of Medicine
关键词
宫颈肿瘤
癌胚抗原
抗原
肿瘤相关
碳水化合物
肿瘤体积变化
鳞状细胞癌抗原
Uterine cervical neoplasms
Carcinoembryonic antigen
Antigens,tumor-associated,carbohydrate
Changes in tumor volume
Squamous cell carcinoma antigen
