癌症2008，Vol.27Issue(6)：612-617,6.
癌胚抗原半衰期在术前癌胚抗原升高的结直肠癌患者中判断预后的作用
The Role of Half-life of Carcinoembryonic Antigen (CEA) in Prognosis Prediction of Colorectal Cancer Patients with Preoperatively Elevated CEA
摘要
Abstract
BACKGROUND & OBJECTIVE:Carcinoembryonic antigen(CEA) monitoring plays an important role in the management of malignancies,especially in colorectal cancer (CRC).The half-life (T1/2) of CEA has also been applied as a new predictor in the surveillance of some malignancies.This study was to examine the preoperative and early postoperative levels of CEA in CRC patients and calculate postoperative T1/2 of CEA to evaluate its potential role in prognosis prediction.METHODS:In this retrospective study, 98 CRC patients who had preoperatively elevated levels of CEA (≥5 μg/L)and serum CEA surveillance after radical operation were included.Postoperative T1,2 of CEA was calculated.Its correlation to prognosis was analyzed.RESULTS:Of the 98 patients,21 had local recurrence or distant metastasis (recurrence group),77 had no recurrence (non-recurrence group).The median value of preoperative CEA level was significantly higher in recurrence group than in non-recurrence group (23.9 μg/L vs.12.3 μg/L,P= 0.010);the median value of postoperative T1/2 of CEA was significantly longer in recurrence group than in non-recurrence group (6.2 days vs.4.7 days,P=0.042);the later the TNM stage was,the poorer the prognosis was (P<0.001).The 3-year disease-free survival (DFS) rate and overall survival (OS) rate were significantly higher in the patients with postoperative T1/2 of CEA of<4.8 days than in those with T1/2 of ≥4.8 days (87% vs.66%,P=0.017;90% vs.80%,P=0.032).The patients at earlier TNM stage had survival benefits both in DFS and OS:the 3-year DFS rates in stage Ⅰ,Ⅱ,and Ⅲ patients were 100%,93%,and 55%,respectively (P<0.001);the 3-year OS rates were 100%,98%,and 77%,respectively (P=0.192).In Cox regression analysis,both TNM stage and postoperative T1/2 of CEA were confirmed to be independent prognostic factors of CRC patients with preoperatively elevated CEA level.CONCLUSIONS:In addition to TNM stage,the T1/2 of CEA may be an independent prognostic factor in CRC patients with preoperatively elevated CEA level.The patients with longer T1/2 of CEA after radical operation have poorer prognosis.关键词
癌胚抗原/半衰期/结直肠肿瘤/预后Key words
Carcinoembryonic antigen/Half-life/Colorectal neoplasm/Prognosis分类
医药卫生引用本文复制引用
袁庶强,周志伟,万德森,陈功,卢震海,王国强,潘志忠..癌胚抗原半衰期在术前癌胚抗原升高的结直肠癌患者中判断预后的作用[J].癌症,2008,27(6):612-617,6.基金项目
广州市科技攻关项目(No.2006Z3-E0451)Grant:Sci-Tech Research Foundation of Guangzhou City(No.2006Z3-E0451) （No.2006Z3-E0451）
