术前CEA、D-二聚体、纤维蛋白原与结直肠癌临床病理特点、分期及预后相关性研究
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摘要
目的分析术前癌胚抗原(CEA)、D-二聚体、纤维蛋白原(FIB)与结直肠癌临床病理特点、分期及预后相关性,探讨CEA、D-二聚体和FIB术前检测在结直肠癌诊疗中的应用价值。方法收集2009年7月至2011年7月该院收治结直肠癌患者158例病理资料,术前检测血浆CEA、D-二聚体和FIB水平,随访并观察所有患者5年生存率,分析血浆CEA、D-二聚体和FIB水平与结直肠癌临床病理特点、TNM分期及预后关系。结果术前158例患者血浆CEA、D-二聚体和FIB水平分别为(4.41±0.84)ng/mL、(0.48±0.13)mg/L和(3.72±0.73)g/L。术前血浆CEA、D-二聚体和FIB水平与肿瘤大小、淋巴结转移相关(P<0.05),与性别、年龄、肿瘤部位、分化程度无关(P>0.05);术前血浆CEA、D-二聚体和FIB水平均与结直肠癌TNM分期相关(P<0.05),经相关性分析,术前血浆CEA、D-二聚体和FIB水平与TNM分期呈正相关(r=0.67,r=0.81,r=0.64,P<0.05);经单因素分析,术前血浆CEA、D-二聚体和FIB水平均是影响术后5年生存率的危险因素(P<0.05),经多因素分析,术前血浆CEA、D-二聚体和FIB水平是影响术后5年生存率的独立危险因素(P<0.05)。结论术前血浆CEA、D-二聚体和FIB水平和结直肠癌临床病理特点及分期相关,高水平CEA、D-二聚体和FIB患者5年生存率较低,是影响预后的独立危险因素。
Objective To analyze the correlation between preoperative carcinoembryonic antigen(CEA),Ddimer,fibrinogen(FIB)and the clinicopathological features,stage and prognosis of colorectal cancer(CRC),and evaluate the application value of CEA,D-dimer and FIB in the diagnosis and treatment of CRC.Methods The pathological files of 158 patients with CRC treated in a hospital from July 2009 to July 2011 were collected.The levels of plasma CEA,D-dimer and FIB were detected before operation.All patients were followed up for a period of 5 years.The relationships between plasma CEA,D-dimer and FIB levels and clinicopathological features,TNM stage and prognosis of CRC were analyzed.Results Before operation,the levels of plasma CEA,D-dimer and FIB were(4.41±0.84)ng/mL,(0.48±0.13)mg/L and(3.72±0.73)g/L,respectively.The preoperative plasma CEA,D-dimer and FIB level were related to tumor size and lymph node metastasis(P<0.05),and have nothing to do with gender,age,tumor site,degree of differentiation(P>0.05),preoperative levels of plasma CEA,D-dimer and FIB were related to TNM stage of CRC(P<0.05).By correlation analysis,the preoperative levels of CEA,D-dimer and FIB in the plasma were positively correlated with the stage of TNM(r=0.67,r=0.81,r=0.64,P<0.05).Univariate analysis showed that preoperative plasma CEA,D-dimer and FIB were the risk factors for postoperative 5-year survival rate(P<0.05).Multivariate analysis showed that preoperative levels of CEA,D-dimer and FIB in the plasma were independent risk factors for the 5-year survival rate(P<0.05).Conclusion Preoperative plasma CEA,D-dimer and FIB levels are correlated with the clinicopathological features and stage of CRC.The 5-year survival rate of patients with high levels of CEA,D-dimer and FIB is low,and plasma CEA,D-dimer and FIB are the independent risk factors influencing the prognosis.
Objective To analyze the correlation between preoperative carcinoembryonic antigen(CEA),Ddimer,fibrinogen(FIB)and the clinicopathological features,stage and prognosis of colorectal cancer(CRC),and evaluate the application value of CEA,D-dimer and FIB in the diagnosis and treatment of CRC.Methods The pathological files of 158 patients with CRC treated in a hospital from July 2009 to July 2011 were collected.The levels of plasma CEA,D-dimer and FIB were detected before operation.All patients were followed up for a period of 5 years.The relationships between plasma CEA,D-dimer and FIB levels and clinicopathological features,TNM stage and prognosis of CRC were analyzed.Results Before operation,the levels of plasma CEA,D-dimer and FIB were(4.41±0.84)ng/mL,(0.48±0.13)mg/L and(3.72±0.73)g/L,respectively.The preoperative plasma CEA,D-dimer and FIB level were related to tumor size and lymph node metastasis(P<0.05),and have nothing to do with gender,age,tumor site,degree of differentiation(P>0.05),preoperative levels of plasma CEA,D-dimer and FIB were related to TNM stage of CRC(P<0.05).By correlation analysis,the preoperative levels of CEA,D-dimer and FIB in the plasma were positively correlated with the stage of TNM(r=0.67,r=0.81,r=0.64,P<0.05).Univariate analysis showed that preoperative plasma CEA,D-dimer and FIB were the risk factors for postoperative 5-year survival rate(P<0.05).Multivariate analysis showed that preoperative levels of CEA,D-dimer and FIB in the plasma were independent risk factors for the 5-year survival rate(P<0.05).Conclusion Preoperative plasma CEA,D-dimer and FIB levels are correlated with the clinicopathological features and stage of CRC.The 5-year survival rate of patients with high levels of CEA,D-dimer and FIB is low,and plasma CEA,D-dimer and FIB are the independent risk factors influencing the prognosis.
引文
[1]刘芳腾,欧阳喜,张官平,等.循环核酸在结直肠癌中的应用及研究现状[J].广东医学,2016,37(11):1734-1738.
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[11]朱莉,张静琼.恶性肿瘤患者凝血和纤溶指标的临床分析以及相关护理对策[J].血栓与止血学,2016,22(5):588-589.
[12]赵如森,孙明,王永涛,等.凝血状态对肺癌的诊断及化疗效果的评估价值[J].实用癌症杂志,2016,20(11):1910-1911.
[13]刘亚岚,刘俊骥,颜赞芳,等.4种血清肿瘤标志物水平对结直肠癌术前分期的意义[J].医学临床研究,2015,32(12):2337-2343.
[14]王俊锋,郭志,唐亮,等.术前纤维蛋白原及D-二聚体与结直肠癌预后的关系[J].中华医学杂志,2013,93(12):906-909.
[15]PICHLER M,HUTTERER G C,STOJAKOVIC T,et al.High plasma fibrinogen level represents an independent negative prognostic factor regarding cancer-specific,metastasis-free,as well as overall survival in a European cohort of non-metastatic renal cell carcinoma patients[J].Br J Cancer,2013,109(5):1123-1129.
[16]张礼.术前癌胚抗原与纤维蛋白原的检测在结直肠癌中的临床价值[D].泸州:西南医科大学,2016.
[2]丁培霖,唐武,施展,等.青年人结直肠癌临床病理特征及外科治疗[J].医学临床研究,2012,29(7):1254-1256.
[3]吴晓尉,汪芳裕.COX-2与结直肠癌关系的研究进展[J].解放军医药杂志,2013,25(12):102-106.
[4]杨泽安.CEA,CA125及CA153在乳腺癌中的检测价值[J].湖南师范大学学报(医学版),2016,13(3):83-85.
[5]余佩芝,秦建川,郑志龙.恶性肿瘤患者凝血指标检测的临床价值[J].血栓与止血学,2016,22(2):165-167.
[6]姚云峰.结直肠癌的TNM分期[J].中国继续医学教育,2011,3(9):8-10.
[7]尹江燕,陈道荣.CEA和CA19-9阳性与结直肠癌临床病理分期相关性研究[J].重庆医学,2014,43(14):1710-1712.
[8]郭佳.血清IL-6、CRP、CA19-9和CEA在胃癌患者中的检测意义[J].湖南师范大学学报(医学版),2016,13(5):63-66.
[9]金鑫.联合检测血清标志物CYFRA21-1、NSE、CEA对肺癌的鉴别诊断意义[J].中国临床研究,2011,24(6):521-522.
[10]李楠,毛夕保,丁晨旻,等.18F-FDGSPECT/CT显像联合CA15-3、CA125和CEA诊断乳腺癌术后复发和(或)转移[J].现代肿瘤医学,2015,20(23):3477-3481.
[11]朱莉,张静琼.恶性肿瘤患者凝血和纤溶指标的临床分析以及相关护理对策[J].血栓与止血学,2016,22(5):588-589.
[12]赵如森,孙明,王永涛,等.凝血状态对肺癌的诊断及化疗效果的评估价值[J].实用癌症杂志,2016,20(11):1910-1911.
[13]刘亚岚,刘俊骥,颜赞芳,等.4种血清肿瘤标志物水平对结直肠癌术前分期的意义[J].医学临床研究,2015,32(12):2337-2343.
[14]王俊锋,郭志,唐亮,等.术前纤维蛋白原及D-二聚体与结直肠癌预后的关系[J].中华医学杂志,2013,93(12):906-909.
[15]PICHLER M,HUTTERER G C,STOJAKOVIC T,et al.High plasma fibrinogen level represents an independent negative prognostic factor regarding cancer-specific,metastasis-free,as well as overall survival in a European cohort of non-metastatic renal cell carcinoma patients[J].Br J Cancer,2013,109(5):1123-1129.
[16]张礼.术前癌胚抗原与纤维蛋白原的检测在结直肠癌中的临床价值[D].泸州:西南医科大学,2016.