Study on relationship between expression of CTCs CA125,CEA and CA19-9 and pathological features in colorectal cancer after operation
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摘要: 目的:分析结直肠癌(CRC)术后血清循环肿瘤细胞(CTCs)、糖类抗原125(CA125)、癌胚抗原(CEA)及糖类抗原19-9(CA19-9)水平与病理特征和复发及转移的相关性。方法:回顾性分析2015年10月—2018年10月行CRC根治术治疗的124例CRC患者临床资料,采集病理特征,检测手术前后血清CTCs、CA125、CEA及CA19-9水平,比较不同临床特征患者血清CTCs、CA125、CEA及CA19-9水平,绘制生存曲线分析2年生存率,并采用ROC曲线分析其水平对CRC术后转移的预测价值。结果:术后血清CTCs、CA125、CEA及CA19-9水平低于术前(P<0.05);不同性别、年龄、肿瘤部位、病理类型、肿瘤直径患者术后血清CTCs、CA125、CEA及CA19-9水平比较差异无统计学意义(P>0.05),TNM分期、肿瘤分化程度及淋巴结转移患者血清CTCs、CA125、CEA及CA19-9水平比较差异有统计学意义(P<0.05)。对124例CRC患者进行2年随访,32例发生转移,18例死亡,2年无进展生存率为85.48%;CTCs、CA125、CEA及CA19-9阳性无进展生存率低于CTCs、CA125、CEA及CA19-9阴性(P<0.05)。血清CTCs、CA125、CEA及CA19-9水平联合预测CRC复发及转移的灵敏度、特异度和ROC曲线下面积高于单独检测(P<0.05)。结论:CRC术后血清CTCs、CA125、CEA及CA19-9水平呈高表达,与病理特征具有一定相关性,可预测CRC术后复发及转移。Abstract: Objective: To analyze the correlation between serum circulating tumor cells(CTCs), carbohydrate antigen 125(CA125), carcinoembryonic antigen(CEA), carbohydrate antigen 19-9(CA19-9) detection before and after surgery, recurrence and metastasis after colorectal cancer(CRC) surgery.Methods: The clinical data of 124 CRC patients who underwent radical surgery in our hospital from October 2015 to October 2018 were retrospectively analyzed. The pathological features were collected. The levels of serum CTCs, CA125, CEA and CA19-9 after surgery were detected. The levels of serum CTCs, CA125, CEA and CA19-9 among patients with different clinical features were compared. The survival curves were drawn to analyze the 2-year survival rate. The predictive value of their levels for metastasis after CRC surgery was analyzed by ROC curves.Results: The serum levels of CTCs, CA125, CEA and CA19-9 after operation were lower than those before operation(P<0.05). There were no significant differences in levels of serum CTCs, CA125, CEA and CA19-9 among patients with different gender, age, tumor sites, pathological types and tumor diameter after surgery(P>0.05), while there were significant differences among patients with different TNM staging, tumor differentiation degree and lymph node metastasis(P<0.05). The 124 CRC patients were followed up for 2 years, there were 32 cases with metastasis and 18 cases died. The 2-year progression-free survival rate was 85.48%. The progression-free survival rate in patients with positive CTCs, CA125, CEA and CA19-9 was lower than that with negative CTCs, CA125, CEA and CA19-9(P<0.05). The sensitivity, specificity and area under ROC curve of serum CTCs, CA125, CEA and CA19-9 levels combined to predict CRC recurrence and metastasis were higher than those detected separately(P<0.05).Conclusion: The levels of serum CTCs, CA125, CEA and CA19-9 were highly expressed after colorectal cancer surgery, which were correlated with pathological characteristics to a certain extent, and could predict postoperative recurrence and metastasis of colorectal cancer.
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