伴有肝转移的结直肠癌患者血清CEA、CA199的分析

doi:10.3877/cma.j.issn.2095-3224.2015.04.12

目的

探讨血清CEA、CA199在晚期结直肠癌中的分布及与临床特征的关系。

方法

将275例CRC患者分别按性别、年龄、肝转移、腹水、肠瘤直径、肠瘤位置、血便、乙肝进行分组，总结分析患者血清CEA、CA199的浓度均值、阳性率及与临床特征的关系。

结果

伴肝转移，肿瘤位于结肠，有血便，有腹水的CRC患者中血清CEA、CA199的浓度均值均明显升高，差异有统计学意义(P<0.05)。而血清CEA、CA199的水平与性别、年龄、肠瘤直径、乙肝无明显相关性(P>0.05)。

结论

血清CEA、CA199可作为早期诊断结直肠癌肝转移的一种有效方法，广泛的用于临床。

关键词: 结直肠肿瘤, 转移, 肝, 生物学标记

Objective

To discuss the relationship between serum CEA, CA199 distribution and clinical features in advanced colorectal cancer.

Methods

275 colorectal cancer patients were classified into groups according to gender, age, liver metastases, ascites, intestinal tumor diameter, intestinal tumor location, bloody stools, and hepatitis B. Retrospectively analyze the relationship between serum CEA, CA199 and those groups applying χ² and t-test.

Results

The mean serufm CEA, CA199 concentrations in CRC patients with liver metastasis, tumor in colon, bloody stools, ascites were significantly increased, and the difference was statistically significant(P<0.05), while there is no correlation with gender, age, intestinal tumor diameter, or hepatitis B(P>0.05).

Conclusions

Serum CEA, CA199 can be used as an early and effective diagnosis of colorectal cancer patients with liver metastases and should be widely used in clinical practice.

Key words: Colorectal neoplasms, Neoplasm metastasis, Liver, Biological markers

表1 结直肠癌患者血清中CEA、CA199浓度均值与临床特征表现的关系表(±s)

临床特征		血清CEA均值	P值	CA199均值	P值
性别		?	?	?	?
?	男	73.34±195.091	0.711	164.31±265.66	0.519
?	女	65.54±130.724	0.711	144.26±234.93	0.519
年龄		?	?	?	?
?	<60岁	73.87±185.129	0.687	143.22±236.827	0.347
?	≥60岁	65.45±152.972	0.687	172.19±272.557	0.347
伴肝转移		?	?	?	?
?	否	20.6±93.649	0	69.36±155.45	0
?	是	106.81±203.923	0	220.28±290.363	0
肠瘤直径		?	?	?	?
?	<5 cm	74.99±186.799	0.583	180±287.236	0.067
?	≥5 cm	63.48±148.135	0.583	123.28±193.806	0.067
肠瘤位置		?	?	?	?
?	结肠	84.22±192.663	0.013	172.66±266.368	0.048
?	直肠	23.68±33.509	0.013	101.39±196.057	0.048
血便		?	?	?	?
?	否	83.4±191.267	0.031	179.8±268.954	0.009
?	是	32.74±85.539	0.031	89.17±188.487	0.009
腹水		?	?	?	?
?	无	53.85±131.725	0	141.31±237.269	0.024
?	有	157.97±294.564	0	235.74±317.841	0.024
乙肝		?	?	?	?
?	无	65.07±153.482	0.407	172.62±264.261	0.066
?	有	84.69±215.256	0.407	108.52±213.08	0.066

表1 结直肠癌患者血清中CEA、CA199浓度均值与临床特征表现的关系表(±s)

临床特征		血清CEA均值	P值	CA199均值	P值
性别		?	?	?	?
?	男	73.34±195.091	0.711	164.31±265.66	0.519
?	女	65.54±130.724	0.711	144.26±234.93	0.519
年龄		?	?	?	?
?	<60岁	73.87±185.129	0.687	143.22±236.827	0.347
?	≥60岁	65.45±152.972	0.687	172.19±272.557	0.347
伴肝转移		?	?	?	?
?	否	20.6±93.649	0	69.36±155.45	0
?	是	106.81±203.923	0	220.28±290.363	0
肠瘤直径		?	?	?	?
?	<5 cm	74.99±186.799	0.583	180±287.236	0.067
?	≥5 cm	63.48±148.135	0.583	123.28±193.806	0.067
肠瘤位置		?	?	?	?
?	结肠	84.22±192.663	0.013	172.66±266.368	0.048
?	直肠	23.68±33.509	0.013	101.39±196.057	0.048
血便		?	?	?	?
?	否	83.4±191.267	0.031	179.8±268.954	0.009
?	是	32.74±85.539	0.031	89.17±188.487	0.009
腹水		?	?	?	?
?	无	53.85±131.725	0	141.31±237.269	0.024
?	有	157.97±294.564	0	235.74±317.841	0.024
乙肝		?	?	?	?
?	无	65.07±153.482	0.407	172.62±264.261	0.066
?	有	84.69±215.256	0.407	108.52±213.08	0.066

表2 结直肠癌患者血清中CEA、CA199阳性率与临床特征表现的关系表

?		血清CEA	P	血清CA199	P	联合检测	P
性别		?	?	?	?	?	?
?	男	54.90%(89/162)	0.991	47.50%(77/162)	0.918	66.70%(108/162)	0.919
?	女	54.90%(62/113)	0.991	46.90%(53/113)	0.918	67.30%(76/113)	0.919
年龄		?	?	?	?	?	?
?	<60岁	54.90%(84/153)	0.998	47.70%(73/153)	0.87	66.00%(101/153)	0.724
?	≥60岁	54.90%(67/122)	0.998	46.70%(57/122)	0.87	68.00%(83/122)	0.724
伴肝转移		?	?	?	?	?	?
?	无	26.50%(31/117)	0	26.60%(30/117)	0	39.30%(46/117)	0
?	有	75.90%(120/158)	0	63.30%(100/158)	0	87.30%(138/158)	0
肠瘤直径		?	?	?	?	?	?
?	<5cm	52.20%(83/159)	0.291	49.70%(79/159)	0.348	65.4%(104/159)	0.536
?	≥5cm	58.60%(68/116)	0.291	44.00%(51/116)	0.348	69.00%(80/116)	0.536
肠瘤位置		?	?	?	?	?	?
?	结肠	59.20%(125/211)	0.009	50.70%(107/211)	0.038	71.60%(151/211)	0.003
?	直肠	40.60%(26/64)	0.009	35.90%(23/64)	0.038	51.60%(33/64)	0.003
腹水		?	?	?	?	?	?
?	无	53.40%(124/232)	0.258	45.70%(106/232)	0.222	65.50%(152/232)	0.255
?	有	62.80%(27/43)	0.258	55.80%(24/43)	0.222	74.4%(32/43)	0.255
血便		?	?	?	?	?	?
?	无	62.10%(126/203)	0	51.70%(105/203)	0.013	74.90%(152/203)	0
?	有	34.70%(25/72)	0	34.70%(25/72)	0.013	44.40%(32/72)	0
乙肝		?	?	?	?	?	?
?	无	58.80%(120/204)	0.027	51.50%(105/204)	0.018	72.10%(147/204)	0.002
?	有	43.70%(31/71)	0.027	35.20%(25/71)	0.018	52.10%(37/71)	0.002

表2 结直肠癌患者血清中CEA、CA199阳性率与临床特征表现的关系表

?		血清CEA	P	血清CA199	P	联合检测	P
性别		?	?	?	?	?	?
?	男	54.90%(89/162)	0.991	47.50%(77/162)	0.918	66.70%(108/162)	0.919
?	女	54.90%(62/113)	0.991	46.90%(53/113)	0.918	67.30%(76/113)	0.919
年龄		?	?	?	?	?	?
?	<60岁	54.90%(84/153)	0.998	47.70%(73/153)	0.87	66.00%(101/153)	0.724
?	≥60岁	54.90%(67/122)	0.998	46.70%(57/122)	0.87	68.00%(83/122)	0.724
伴肝转移		?	?	?	?	?	?
?	无	26.50%(31/117)	0	26.60%(30/117)	0	39.30%(46/117)	0
?	有	75.90%(120/158)	0	63.30%(100/158)	0	87.30%(138/158)	0
肠瘤直径		?	?	?	?	?	?
?	<5cm	52.20%(83/159)	0.291	49.70%(79/159)	0.348	65.4%(104/159)	0.536
?	≥5cm	58.60%(68/116)	0.291	44.00%(51/116)	0.348	69.00%(80/116)	0.536
肠瘤位置		?	?	?	?	?	?
?	结肠	59.20%(125/211)	0.009	50.70%(107/211)	0.038	71.60%(151/211)	0.003
?	直肠	40.60%(26/64)	0.009	35.90%(23/64)	0.038	51.60%(33/64)	0.003
腹水		?	?	?	?	?	?
?	无	53.40%(124/232)	0.258	45.70%(106/232)	0.222	65.50%(152/232)	0.255
?	有	62.80%(27/43)	0.258	55.80%(24/43)	0.222	74.4%(32/43)	0.255
血便		?	?	?	?	?	?
?	无	62.10%(126/203)	0	51.70%(105/203)	0.013	74.90%(152/203)	0
?	有	34.70%(25/72)	0	34.70%(25/72)	0.013	44.40%(32/72)	0
乙肝		?	?	?	?	?	?
?	无	58.80%(120/204)	0.027	51.50%(105/204)	0.018	72.10%(147/204)	0.002
?	有	43.70%(31/71)	0.027	35.20%(25/71)	0.018	52.10%(37/71)	0.002

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Analysis of serum CEA and CA199 in colorectal cancer patients with liver metastases

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Analysis of serum CEA and CA199 in colorectal cancer patients with liver metastases