摘要
目的构建术前癌胚抗原(CEA)、糖类抗原19-9(CA19-9)模型,预测结直肠癌(CRC)患者的生存时间。方法收集江门市中心医院就诊的313例CRC患者,利用Beckman Access化学发光免疫分析仪检测CRC患者术前血清CEA、CA19-9水平,运用χ^(2)检验评估其与CRC患者临床病理参数的关系,Kaplan-Meier生存分析和Cox多因素分析分别评估CRC患者生存及预后。结果CEA、CA19-9均与CRC患者pT、pN、pM分期,临床Ⅰ、Ⅱ、Ⅲ、Ⅳ分期,进展,复发,脉管浸润,转移部位等因素相关(P<0.05)。CEA升高患者的总生存时间(OS)较CEA正常患者缩短(76.85个月vs 110.83个月,P=0.000)。CA19-9升高患者的OS也有相同趋势(P=0.000)。Cox多因素分析发现CEA、CA19-9是预测CRC患者生存的独立因素(HR分别为2.190和2.874;95%CI分别为1.486~3.225和1.947~4.242;P均<0.05)。联合CEA、CA19-9构建模型公式,赋予CEA正常为0分,CEA升高为1分,CA19-9正常为0分,CA19-9升高为1分,并设CC值=CEA评分+CA19-9评分,结果发现CC值最高患者的OS最短,CC值最低患者的OS最长(P<0.05)。结论构建的CEA、CA19-9模型公式可以有效地预测CRC患者预后。
Objective To construct a model for predicting the survival time of colorectal cancer(CRC)patients based on the preoperative carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels.Methods 313 patients with CRC from Jiangmen Central Hospital were collected and their preoperative serum CEA and CA19-9 levels were detected using a Beckman Access chemiluminescence immunoassay analyzer.Theχ^(2)test was used to evaluate the relationships between CEA and clinical pathological factors and between CA19-9 and clinical pathological factors,and the Kaplan-Meier survival analysis and Cox multivariate analysis were used to assess the survival and prognosis of patients,respectively.Results CEA and CA19-9 levels were correlated with TNM staging,clinical stagesⅠ,Ⅱ,Ⅲ,andⅣ,progression,recurrence,vascular invasion,and metastatic sites of CRC(P<0.05).The overall survival time(OS)of patients with elevated CEA was shorter than that of patients with normal CEA,with a total of 76.85 months,while the OS of patients with normal CEA was 110.83 months(P=0.000).The same trend was observed in patients with elevated CA19-9(P=0.000).Cox multivariate analysis found that CEA and CA19-9 were independent predictors of survival in CRC patients(HR=2.190 and 2.874,95%CI=1.486-3.225 and 1.947-4.242,respectively;P<0.05).A model formula combining CEA and CA19-9 was constructed,assigning a score of 0 for normal CEA,1 for elevated CEA,and 0 for normal CA19-9,1 for elevated CA19-9.The CC value was set to equal CEA score+CA19-9 score.It was found that the patients with the highest CC value had the shortest OS,while the patients with the lowest CC value had the longest OS(P<0.05).Conclusion The established CEA and CA19-9 model formula can effectively distinguish the prognosis of CRC patients.
作者
黄俊强
HUANG Junqiang(Department of Laboratory Medicine,Jiangmen Central Hospital,Jiangmen 529000,Guangdong,China)
出处
《临床检验杂志》
CAS
2024年第1期67-72,共6页
Chinese Journal of Clinical Laboratory Science
基金
广东省医学科学技术研究基金(B2022331)。
关键词
结直肠癌
癌胚抗原
糖类抗原19-9
生存时间
colorectal cancer
carcinoembryonic antigen
carbohydrate antigen 19-9
survival time
