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中华普通外科学文献(电子版) ›› 2017, Vol. 11 ›› Issue (06) : 380 -384. doi: 10.3877/cma.j.issn.1674-0793.2017.06.005

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论著

术前血清癌胚抗原联合外周血小板检测对结直肠癌患者预后评估的价值
黄利军1, 魏波1, 郑宗珩1, 方佳峰1, 陈图锋1, 刘健培1, 卫洪波1, 黄勇1,()   
  1. 1. 510630 广州,中山大学附属第三医院胃肠外科
  • 收稿日期:2017-07-26 出版日期:2017-12-01
  • 通信作者: 黄勇
  • 基金资助:
    国家自然科学基金面上项目(81472825); 广东省自然科学基金项目(2014A030313078); 广东市科技计划项目产学研协同创新重大专项资助项目(2014Y2-00503); 广东省科技计划项目产学研合作项目(2014B090901066)

Prognostic value of combining preoperative serum CEA and peripheral platelet detection in patients with colorectal cancer

Lijun Huang1, Bo Wei1, Zongheng Zheng1, Jiafeng Fang1, Tufeng Chen1, Jianpei Liu1, Hongbo Wei1, Yong Huang1,()   

  1. 1. Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2017-07-26 Published:2017-12-01
  • Corresponding author: Yong Huang
  • About author:
    Corresponding author: Huang Yong, Email:
引用本文:

黄利军, 魏波, 郑宗珩, 方佳峰, 陈图锋, 刘健培, 卫洪波, 黄勇. 术前血清癌胚抗原联合外周血小板检测对结直肠癌患者预后评估的价值[J/OL]. 中华普通外科学文献(电子版), 2017, 11(06): 380-384.

Lijun Huang, Bo Wei, Zongheng Zheng, Jiafeng Fang, Tufeng Chen, Jianpei Liu, Hongbo Wei, Yong Huang. Prognostic value of combining preoperative serum CEA and peripheral platelet detection in patients with colorectal cancer[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(06): 380-384.

目的

探讨术前外周血小板计数(PLT)与血清癌胚抗原水平(CEA)联合检测对结直肠癌患者预后评估的价值。

方法

回顾性分析2010年1月至2012年5月中山大学附属第三医院收治的297例结直肠癌患者临床病理资料,随访5年。卡方检验分析CEA阳性(CEA≥5 μg/L)与PLT计数阳性(PLT≥350×109/L)的影响因素。Kaplan-Meier法绘制生存曲线,Log-rank检验比较生存率;COX回归分析预后的独立危险因素。

结果

(1)术前血清CEA阳性与结直肠癌患者脉管癌栓、神经侵犯、浸润深度、淋巴结转移、远处转移及TNM分期较晚相关(χ2=5.743、5.699、10.308、15.543、43.537、21.199,P=0.017、0.017、0.028、<0.01、<0.01、<0.01);PLT阳性与性别、年龄、肿瘤位置、肿瘤大小、浸润深度、远处转移显著相关(χ2=13.409、7.749、8.496、7.324、9.295、9.196,P<0.01、0.005、0.014、0.007、0.038、0.002)。(2)生存分析提示术前血清CEA阳性、外周PLT阳性均提示不良预后(χ2=36.926、6.892,均P<0.01)。CEA及PLT双阴性、单阳性以及双阳性患者的5年生存率分别为80.2%、51.1%、45.5%,中位生存时间分别为69、61、28个月,差异有统计学意义(χ2=36.506,P<0.01)。(3)COX多因素回归分析提示肿瘤位置、神经侵犯、远处转移、TNM分期是影响患者预后的独立危险因素(均P<0.05)。

结论

术前血清CEA与外周血小板联合检测可为判断结直肠癌患者预后提供重要信息。

Objective

To investigate the prognostic value of preoperative serum carcinoembryonic antigen (CEA) combined with peripheral platelet count (PLT) in colorectal cancer patients.

Methods

From January 2010 to May 2012, clinical-pathological data of two hundred and ninety-seven colorectal cancer patients treated in the Third Affiliated Hospital of Sun Yat-sen University who finished 5 years’ follow-up were analyzed retrospectively. The risk factors of CEA positive (CEA≥5 μg/L) and PLT positive (PLT≥350×109/L) were judged by Chi-square test. The survival analysis with Kaplan-Meier regression and COX regression were done to investigate the prognostic value of CEA and PLT in colorectal cancer.

Results

(1) Positivity of preoperative serum CEA was significantly related to vascular cancer embolus, nerve invasion, the depth of invasion, lymph node metastasis, distant metastasis and TNM stages (χ2=5.743, 5.699, 10.308, 15.543, 43.537, 21.199, P=0.017, 0.017, 0.028, <0.01, <0.01, <0.01), while gender, age, the size of tumor, tumor position, the depth of invasion and distant metastasis were significantly related to PLT positivity (χ2=13.409, 7.749, 8.496, 7.324, 9.295, 9.196, P<0.01, 0.005, 0.014, 0.007, 0.038, 0.002). (2) Survival analysis found that positive CEA, PLT and their combination suggested poor prognosis (χ2=36.926, 6.892, 34.821, P<0.01). The 5-year survival rate of neither, either and both positivity of CEA and PLT were 80.2%, 51.1%, 45.5%, while the median survival time was 69, 61, 28 months with statistical difference (χ2=36.506, P<0.01). (3) COX regression revealed that the location of the tumor, nerve invasion, distant metastasis and TNM stages were the independent risk factors for the colorectal cancer (all P<0.05).

Conclusion

Combination of preoperative serum CEA and peripheral PLT can provide prognostic information for patients with colorectal cancer.

表1 术前血清CEA、外周PLT与结直肠癌患者临床病理因素的关系(例,χ2检验)
图1 不同指标结直肠癌患者的生存曲线A为CEA阳性患者生存显著差于阴性患者;B为PLT阳性患者生存显著差于阴性患者;C为并联检测阳性(CEA或PLT阳性)患者生存显著差于阴性患者;D为CEA及PLT双阴性、单个阳性及双阳性患者生存曲线图,双阳性患者预后最差
表2 影响结直肠癌患者预后的COX多因素回归分析
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