摘要
Abstract
Objective To explore the predictive value of serum carbohydrate antigen153(CA153)and carbohydrate antigen242(CA242)for postoperative recurrence and metastasis of colorectal cancer.Meth-ods A total of 100 patients with colorectal cancer from May 2022 to December 2023 were selected as par-ticipants.According to the postoperative progression,they were divided into a recurrence and metastasis group and a tumor-free survival group.The clinical data of the two groups of patients and the serum levels of postoperative CA153,CA242 and carcinoembryonic antigen(CEA)were collected.Multivariate Cox re-gression analysis was used to analyze the risk factors,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of each indicator.Results The 100 patients were followed up for 10-27 months,with a median follow-up time of 18 months.A total of 37 patients had postoperative re-currence and metastasis,including 25 cases of recurrence,6 cases of liver metastasis,3 cases of lung metas-tasis and 3 cases of bone metastasis.There were statistically significant differences in the degree of differ-entiation and pathological stage between the recurrence and metastasis group and the tumor-free survival group(P＜0.05).There were no statistically significant differences in age,gender,tumor location and lymphatic vessel invasion between the two groups of patients(P＞0.05).The serum levels of CA153,CA242 and CEA in the recurrence and metastasis group were significantly higher than those in the tumor-free survival group(P＜0.05).Multivariate Cox regression analysis showed that the degree of differentia-tion(OR=2.275,95％CI:1.359-5.526),pathological stage(OR=5.265,95％CI:2.386-17.636),CA242(OR=2.051,95％CI:1.428-4.300)and CEA(OR=2.024,95％CI:1.204-4.263)were risk factors for postoperative recurrence and metastasis of colorectal cancer patients(P＜0.05),while CA153 was not a risk factor(P＞0.05).ROC curve analysis showed that the area under the ROC curve(AUC)of serum CA153 for predicting postoperative recurrence and metastasis was 0.572(95％CI:0.439-0.826),with a sensitivity of 44.3％and a specificity of 85.2％.The AUC of CA242 for predicting postop-erative recurrence and metastasis was 0.744(95％CI:0.584-0.927),with a sensitivity of 74.2％and a specificity of 70.8％.The AUC of CEA for predicting postoperative recurrence and metastasis was 0.702(95％CI:0.632-0.953),with a sensitivity of 71.6％and a specificity of 65.3％.Conclusion Monitoring the serum level of CA242 after colorectal cancer surgery can help clinicians evaluate the risk of recurrence and metastasis,and its efficacy may even be better than that of CEA,while the value of CA153 is limited.关键词
结直肠癌/手术/复发/转移/糖类抗原153/糖类抗原242Key words
Colorectal cancer/Surgery/Recurrence/Metastasis/Carbohydrate antigen153/Carbohydrate antigen242
