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目的探讨癌胚抗原(CEA)、糖类多肽抗原19-9(CA19-9)水平与晚期结直肠癌化疗预后的关系。方法选取2012年6月—2015年5月于嵊州市中医院进行治疗的晚期结直肠癌患者78例,均采取XELOX化疗,3周为一周期,共化疗3~6个周期。随访时间8~35个月。测定化疗前、后CEA、CA19-9水平,并分析影响预后的影响因素。结果随访结束时,有19例患者存活,生存率为24.36%,中位生存时间为20个月;晚期结直肠癌患者不同病理分化程度的生存率差异存在统计学意义(Z=22.158,P<0.05);化疗前CEA水平正常的患者中位生存时间为33.80个月,化疗前升高但化疗后下降≥25%的患者中位生存时间为21.25个月,化疗前升高但化疗后下降<25%的患者中位生存时间为17.99个月,三者之间生存时间差异存在统计学意义(χ~2=10.020,P<0.05);化疗前CA19-9水平正常的患者中位生存时间为32.60个月,化疗前升高但化疗后下降≥25%的患者中位生存时间为19.90个月,化疗前升高但化疗后下降<25%的患者中位生存时间为18.31个月,三者之间生存时间差异存在统计学意义(χ~2=6.245,P<0.05);COX多因素回归结果显示,CEA水平、分化程度为晚期结直肠癌患者预后的独立影响因素。结论 CEA、CA19-9水平可预测预后情况,病理分化程度、CEA水平可作为预测预后的独立因素。
Objective To investigate the relationship between carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and prognosis of advanced colorectal cancer. Methods Seventy-eight patients with advanced colorectal cancer who were treated in Shengzhou Hospital of Traditional Chinese Medicine from June 2012 to May 2015 were enrolled in this study. All patients were treated with XELOX chemotherapy for 3 weeks and 3 to 6 cycles. Follow-up time of 8 to 35 months. The levels of CEA and CA19-9 before and after chemotherapy were measured, and the influencing factors of prognosis were analyzed. Results At the end of follow-up, 19 patients survived, the survival rate was 24.36%, and the median survival time was 20 months. There was significant difference in the survival rates of patients with advanced colorectal cancer with different pathological grade (Z = 22.158, P < 0.05). The median survival time of patients with normal CEA before chemotherapy was 33.80 months. The median survival time before chemotherapy was 21.25 months after chemotherapy but decreased more than 25% after chemotherapy. The median survival time was increased before chemotherapy but decreased after chemotherapy. The median survival time in 25% of patients was 17.99 months. There was a significant difference in survival time between the two groups (χ ~ 2 = 10.020, P <0.05). The median survival time of patients with normal CA19-9 level before chemotherapy was The median survival time was 32.60 months. The median survival time was 19.90 months in patients who had elevated before chemotherapy, but decreased more than 25% after chemotherapy. The median survival time was 18.31 months in patients with elevated chemotherapy before chemotherapy but less than 25% after chemotherapy. (Χ ~ 2 = 6.245, P <0.05). The multivariate regression analysis showed that the level of CEA and the degree of differentiation were independent prognostic factors in patients with advanced colorectal cancer. Conclusion CEA, CA19-9 levels can predict the prognosis, pathological differentiation, CEA levels can be used as an independent prognostic factor.