The Relationship Between Preoperative Combined Detection of Serum CEA,CA153,CA724,and CA199 Levels and Clinical Staging and Prognosis of Rectal Cancer
Objective To investigate the relationship between the levels of carcinoembryonic antigen(CEA),carbohy-drate antigen 153(CA153),carbohydrate antigen 724(CA724)and carbohydrate antigen 199(CA199)before operation and the clinical stage and prognosis of rectal cancer.Methods 196 patients with rectal cancer were randomly selected as the study ob-jects,and the preoperative serum CEA,CA153,CA724 and CA199 levels were compared in patients with different stages and dif-ferent prognosis.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients with rec-tal cancer.The predictive value of preoperative serum CEA,CA153,CA724 and CA199 levels in patients with rectal cancer was analyzed by receiver operating characteristic(ROC)curve.Results There were statistically obvious differences in preoperative serum levels of CEA,CA153,CA724,and CA199 among patients with stage Ⅰ～Ⅳ rectal cancer(P＜0.05),and with the in-crease of stages,there was an upward trend;the difference in lymph node metastasis,degree of differentiation,depth of infiltration,and tumor diameter between the poor prognosis group and the good prognosis group was statistically obvious(P＜0.05);compared with the good prognosis group,the poor prognosis group had obviously higher levels of preoperative serum CEA,CA153,CA724,and CA199(P＜0.05);the results of multivariate Logistic regression analysis showed that serum CEA,CA153,CA724,CA199,lymph node metastasis,low differentiation,and depth of infiltration(T3～T4)were independent risk factors for poor prognosis in rectal cancer patients(P＜0.05).The ROC results showed that the AUC of serum CEA,CA153,CA724,and CA199 levels alone in predicting the prognosis of rectal cancer patients was 0.825,0.803,0.793,and 0.766,respectively,with sensitivity of 73.08％,67.31％,69.23％,and 71.15％,and specificity of 85.61％,84.89％,86.33％,and 87.05％,respectively;the AUC of combined prediction of serum CEA,CA153,CA724,and CA199 levels for the prognosis of rectal cancer patients was 0.883(95％CI:0.828～0.925),which was obviously higher than the AUC predicted by serum CEA alone(Z=2.134,P=0.033),CA153 alone(Z=2.167,P=0.030),CA724 alone(Z=2.288,P=0.022),and CA199 alone(Z=2.801,P=0.005).Conclu-sion The preoperative serum levels of CEA,CA153,CA724,and CA199 in rectal cancer patients are related to clinical staging and prognosis,and the combined detection of the 4 has high predictive value for prognosis.
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