首页|晚期结直肠癌患者靶向治疗前后血清CEA、CA125、CA199变化及与疗效的关系

晚期结直肠癌患者靶向治疗前后血清CEA、CA125、CA199变化及与疗效的关系

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目的 分析晚期结直肠癌(CRC)患者靶向治疗前后血清癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)变化及与临床疗效的关系.方法 选取2018年1月至2020年1月收治的110例晚期CRC患者,均接受靶向治疗,对比完全缓解(CR)+部分缓解(PR)组、疾病稳定(SD)组、疾病进展(PD)组治疗前后血清CEA、CA125、CA199,ROC曲线分析CEA、CA125、CA199单独与联合诊断对晚期CRC治疗效果的预测价值,对所有研究对象随访直至2022年5月31日,对比不同血清CEA、CA125、CA199水平患者总生存期(OS),Spearman相关性分析OS与血清CEA、CA125、CA199的相关性.结果 110例患者经靶向治疗,CR 38例(34.55％);PR 44例(40.00％);SD 20例(18.18％);PD 8例(7.27％).CR+PR组治疗前血清CEA、CA125、CA199与SD组、PD组比较,差异无统计学意义(P＞0.05);CR+PR组治疗后血清CEA、CA125、CA199均低于SD组、PD组,差异有统计学意义(P＜0.05).CEA+CA125+CA199 诊断灵敏度(89.96％)、特异度(91.34％)均高于 CEA(82.13％、70.13％)、CA125(76.05％、74.33％)、CA199(78.77％、83.16％)单独诊断,差异有统计学意义(P＜0.05).血清 CEA＜5 ng/mL、CA125＜35 U/mL、CA199＜37 U/mL组患者OS均高于血清CEA≥5 ng/mL、CA125≥35 U/mL、CA199≥37 U/mL组患者,差异有统计学意义(P＜0.05).OS 与血清 CEA、CA125、CA199 均呈负相关性(r 值=-4.967、-5.028、-5.134,P＜0.05).结论 晚期 CRC 患者患者靶向治疗期间血清CEA、CA125、CA199水平降低,预示着临床疗效较好,患者总生存期延长.
Changes in serum CEA,CA125 and CA199 in patients with advanced colorectal cancer before and after targeted therapy and their relationship with clinical efficacy
Objective To analyze the changes in serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and carbohydrate antigen 199(CA199)in patients with advanced colorectal cancer(CRC)before and after targeted therapy and their relationship with clinical efficacy.Methods A total of 110 patients with advanced CRC admitted from January 2018 to January 2020 were selected.All of them received targeted therapy.Serum CEA,CA125 and CA199 before and after treatment in patients of the complete remission(CR)+partial remission(PR)group,stable disease(SD)group and disease progression(PD)group were compared.Receiver operating characteristic(ROC)curves were plotted to identify the single detection of serum CEA,CA125 and CA199 and their combined detection in predicting advanced CRC.All patients were followed up until 31st May 2022.The overall survival(OS)in patients with different serum levels of CEA,CA125,and CA199 were compared.The correlation of OS with serum CEA,CA125,and CA199 was analyzed by Spearman correlation.Results A total of 110 patients received targeted therapy,including 38(34.55％),44(40.00％),20(18.18％)and 8(7.27％)cases of CR,PR,SD and PD.No significant differences were detected in serum CEA,CA125 and CA199 before treatment among CR+PR group,SD group and PD group(P＞0.05).After treatment,patients in CR+PR group had significantly lower serum CEA,CA125 and CA199 than those of SD group and PD group(P＜0.05).The diagnostic sensitivity(89.96％vs 82.13％vs 76.05％vs 78.77％)and specificity(91.34％vs 70.13％vs 74.33％vs 83.16％)of the combined detection of serum CEA,CA125 and CA199 was significantly higher than that of the single detection of CEA,CA125 and CA199(P＜0.05).The OS of patients with serum CEA＜5ng/mL,CA125＜35U/mL or CA199＜37U/mL group was significantly higher than that of the counterpart(P＜0.05).OS was negatively correlated with serum CEA,CA125,and CA199(r=-4.967,-5.028,-5.134,respectively;P＜0.05).Conclusion Serum levels of CEA,CA125 and CA199 decrease during targeted therapy in patients with advanced CRC,and their lower levels predict better clinical efficacy and longer overall survival.

advanced colorectal cancertargeted therapycarcinoembryonic antigencarbohydrate antigen 125carbohydrate antigen 199

郭鹏伟、赵红梅、王毅、郑波、崔海涛

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075000 河北省张家口市第一医院普通外科

河北省张家口市第五医院检验科

晚期结直肠癌 靶向治疗 癌胚抗原 糖类抗原125 糖类抗原199

河北省医学科学研究课题

20221886

2024

10.3969/j.issn.1002-7386.2024.12.020

河北医药
河北省医学情报研究所

河北医药

CSTPCD
影响因子：1.075
ISSN：1002-7386
年,卷(期)：2024.46(12)