Predictive value of preoperative detection of CEA and CA199 for prognosis in patients with stage Ⅱ-Ⅲ colorectal cancer
10.3760/cma.j.issn.1671-0274.2015.09.016
- VernacularTitle:术前检测癌胚抗原和糖链抗原199对结直肠癌Ⅱ～Ⅲ期患者预后的判断价值
- Author:
Lei CHEN
1
;
Beihai JIANG
;
Jiabo DI
;
Chenghai ZHANG
;
Zaozao WANG
;
Nan ZHANG
;
Jiadi XING
;
Ming CUI
;
Hong YANG
;
Zhendan YAO
;
Xiangqian SU
Author Information
1. 100142,北京大学肿瘤医院暨北京市肿瘤防治研究所 恶性肿瘤发病机制及转化研究教育部重点实验室 胃肠肿瘤微创外科
- Keywords:
Colorectal neoplasms;
Carcinoembryonic antigen (CEA);
Carbohydrate atigen 199(CA199);
Prognosis
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(9):914-919
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of preoperative detection of CEA and CA199 for prognosis in patients with stage Ⅱ-Ⅲ colorectal cancer (CRC). Methods Clinicopathological and follow-up data of 266 patients with stage Ⅱ-Ⅲ colorectal cancer confirmed by pathology and undergoing radical resection in our department from 2004 to 2006 were retrospectively analyzed. The 5-year overall survival(OS) and disease-free survival(DFS) between normal CEA patients and increased CEA ones, and normal CA199 patients and increased CA199 ones were compared respectively. Moreover, the risk factors of OS and DFS were examined. Results Among these 266 patients, 119 (44.7%) had preoperative elevated CEA, and 74 (27.8%) had increased CA199. The median follow-up time was 63 months. Kaplan-Meier survival curves indicated that patients with elevated preoperative CEA had worse 5-year overall survival (OS) (54.6% vs. 72.8%, P=0.001) and disease-free survival (DFS)(75.2% vs. 83.3%, P=0.042) than those with normal CEA respectively. Meanwhile, patients with elevated CA199 had worse OS(45.9% vs. 71.9%, P=0.000) and DFS (74.2% vs. 81.8%, P=0.047) than those with normal CA199 respectively. Multivariate analysis revealed that male (HR=3.016, 95% CI:1.536-5.919, P=0.001), lymph node metastasis (HR=2.278, 95% CI:1.272-4.081, P=0.006), and preoperative elevated CEA (HR =1.794, 95% CI:1.022-3.149, P =0.042) were independent prognostic factors of DFS. While vascular thrombosis (HR=2.041, 95% CI:1.294-3.221, P=0.002), lymph node metastasis (HR=2.480, 95% CI:1.548-3.972, P=0.000), and preoperative elevated CA199 (HR=2.145, 95% CI:1.414-3.254, P=0.000) were independent prognostic factors of OS in patients with stage Ⅱ-Ⅲ CRC. Conclusion Combined detection of preoperative CEA and CA199 can be used in evaluating the prognosis of patients with stage Ⅱ-Ⅲ CRC.
