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中华结直肠疾病电子杂志 ›› 2018, Vol. 07 ›› Issue (05) : 453 -457. doi: 10.3877/cma.j.issn.2095-3224.2018.05.009

所属专题: 文献

论著

术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用
马运宾1, 刘骞2,()   
  1. 1. 100122 北京,北京市朝阳区三环肿瘤医院腹部外科;100021 北京,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科
    2. 100021 北京,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科
  • 收稿日期:2017-12-19 出版日期:2018-10-25
  • 通信作者: 刘骞
  • 基金资助:
    国家重点研发计划精准医学专项资助项目(No.2016YFC905301)

Combined application of preoperative serum CEA, CA19-9 and CA50 levels in liver metastasis of colorectal cancer

Yunbin Ma1, Qian Liu2,()   

  1. 1. Department of Abdominal Surgery, Beijing Third Ring Cancer Hospital, Chaoyang District, Beijing 100122, China; Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
    2. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
  • Received:2017-12-19 Published:2018-10-25
  • Corresponding author: Qian Liu
  • About author:
    Corresponding author: Liu Qian, Email:
引用本文:

马运宾, 刘骞. 术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用[J/OL]. 中华结直肠疾病电子杂志, 2018, 07(05): 453-457.

Yunbin Ma, Qian Liu. Combined application of preoperative serum CEA, CA19-9 and CA50 levels in liver metastasis of colorectal cancer[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(05): 453-457.

目的

研究术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用价值。

方法

选择2015年1月至2017年1月在中国医学科学院肿瘤医院接受手术治疗的结直肠癌患者316例为研究对象,其中结直肠癌伴有肝转移的患者158例作为实验组,并按照性别、年龄等匹配结直肠癌不伴有肝转移的患者158例作为对照组。对所有患者的术前血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)以及糖类抗原50(CA50)进行检测,采用单因素及多因素分析以上肿瘤标志物单独或联合检测在结直肠癌肝转移中的预测价值。

结果

单因素及多因素分析结果表明,术前血清CEA、CA19-9、CA50升高与结直肠癌发生肝转移显著相关(P<0.05),CEA、CA19-9、CA50单独预测结直肠癌肝转移的敏感度分别为62.7%、57.4%、67.1%;特异度分别为58.2%、53.5%、56.6%。CEA、CA19-9、CA50联合诊断预测直肠癌肝转移的敏感度和特异度分别为74.3%、76.3%。

结论

术前血清CEA、CA19-9、CA50升高是结直肠癌肝转移的独立预测因素,但三者单独预测结直肠癌肝转移的敏感度和特异度均较低。三者联合检测对于预测结直肠癌肝转移的敏感度和特异度均较高,可以作为结直肠癌肝转移的预测模型。

Objective

To study the application value of preoperative serum CEA, CA19-9 and CA50 in the prediction of liver metastasis of colorectal cancer.

Methods

A total of 316 patients with colorectal cancer who underwent surgery at the Cancer Hospital of Chinese Academy of Medical Sciences from January 2015 to January 2017 were enrolled in this study. Among them, 158 patients with colorectal cancer and liver metastases were included in the observation group. Other 158 case-matched patients with colorectal cancer without liver metastases were included in the control group. Preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and carbohydrate antigen 50 (CA50) were measured in all patients. The univariate and multivariate analysis of the above tumor markers were used alone or in combination in this study.

Results

The results of univariate and multivariate analysis showed that increased preoperative serum CEA, CA19-9 and CA50 significantly correlated with liver metastases in patients with colorectal cancer (P<0.05). The sensitivity of CEA, CA19-9 and CA50 in predicting colorectal cancer liver metastasis was 62.7%, 57.4% and 67.1%, respectively; the specificities were 58.2%, 53.5%, 56.6%, respectively. The sensitivity and specificity of combined diagnosis of CEA, CA19-9, and CA50 for liver metastasis in colorectal cancer were 74.3% and 76.3%, respectively.

Conclusions

The preoperative serum CEA, CA19-9 and CA50 were independent predictors of liver metastasis in patients with colorectal cancer. But these three tumor markers predicted liver metastasis with low sensitivity and specificity. The combined application of these three tumor markers had higher sensitivity and specificity in predicting liver metastasis for patients with colorectal cancer and could be used as a predictive model for liver metastasis of colorectal cancer.

表1 两组患者一般情况对比分析
表2 单因素logistics回归分析
表3 多因素logistic回归分析
图1 CEA、CA19-9、CA50联合检测的ROC曲线图
表4 CEA、CA19-9、CA50单独检测的敏感度和特异度分析
表5 CEA、CA19-9、CA50联合检测的敏感度和特异度分析
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