结直肠癌患者血清肿瘤标志物水平与临床病理学特征的关系

荆结线; 杜丽莉; 王文达; 田保国; 张鑫; 赵先文; 韩存芝

结直肠癌患者血清肿瘤标志物水平与临床病理学特征的关系

The Correlation between Serum levels of Tumor Markers and Clinical Pathological Characteristics in Colorectal Cancer Patients

摘要

摘要: 目的: 探讨结直肠癌患者手术前血清中肿瘤标志物CEA、CA199、CA242与临床生理病理特征的关系。 方法: ELISA法检测602例结直肠癌患者血清中CEA、CA199、CA242水平。 结果: 1)结直肠癌患者血清中CEA、CA199、CA242水平与性别、年龄、病理类型之间均无密切关系。2)结肠癌患者血清中CEA水平(23.29±7.64)μg/ml、CA199水平(43.11±6.85)U/ml和CA242水平(40.27±6.13)U/ml明显高于直肠癌患者(11.13±1.99)μg/ml、(34.43±3.36)U/ml、(26.06±2.29)U/ml,均P<0.001。3)淋巴结转移的结直肠癌患者CA199水平(47.10±5.04)U/ml和CA242水平(37.70±3.89)U/ml高于无淋巴结转移者(22.38±2.57)U/ml、(18.99±2.15)U/ml均P<0.001。4)远隔脏器转移的结直肠癌患者CEA水平(30.72±3.61)μg/ml、CA199水平(92.22±12.20)U/ml、CA242水平(68.08±7.85)U/ml高于无转移者(9.83±1.62)μg/ml、(26.95±2.27)U/ml、(21.80±1.80)U/ml,均P<0.001。5)Duck’s分期不同,结直肠癌患者CEA、CA199、CA242水平也有差异。随着期别的变化,CEA、CA199、CA242水平也明显升高,P<0.005～<;0.001。6)浸润程度不同,CEA、CA199、CA242水平存在差异,浸全层达浆膜外的患者CEA、CA199、CA24水平明显高于浸全层、浸深肌层和浸浅肌层的患者,P<0.05～<0.005;而三者之间无统计学差异。7)CEA与生长类型无密切相关,只有浸润型的患者,血清中CA199、CA242水平明显高于溃疡型、蕈伞型和缩管型,P<0.05～<0.01。8)肿瘤大小与血清中CEA水平无关;随着肿瘤体积的增大,血清中CA199、CA242水平明显升高。P<0.002～<0.001。9)结直肠癌患者血清中CEA与CA199、CA242之间存在正相关(分别为r=0.189,r=0.194),P<0.01;CA199与CA242之间的相关系数r=0.884,P<0.001。 结论: 1)结直肠患者血清中CEA、CA199、CA242水平与肿瘤的部位和远处转移存在密切相关;2)血清中CA199、CA242水平与结直肠癌患者的各种生理及病理特征存在更加密切关系;3)血清中CEA、CA199、CA242存在正相关,是监测结直肠癌患者病情的最佳组合。

Abstract: Objective: To investigate the relationship between the serum concentrations of CEA, CA199, and CA242and clinical pathological characteristics in colorectal patients. Methods: We employed ELISA to detect the serum concen-trations of CEA, CA199, and CA242 in 602 patients with colorectal cancer. Results: (1) The preoperative serum levels ofCEA, CA199, and CA242 were not correlated with age, gender or pathological type of the tumor(P>0.05). (2) The preoper-ative serum levels of CEA(23.29± 7.64 μ g/ml), CA199(43.11± 6.85 U/ml), and CA242 (40.27± 6.13 U/ml) in patients withcolon cancer were significantly higher than those in patients with rectal cancer (11.13± 1.99 μ g/ml, 34.43± 3.36 U/ml, and26.06± 2.29 U/ml, respectively; P<0.001). (3) The levels of CA199(47.10± 5.04 U/ml) and CA242(37.70± 3.89 U/ml) in pa-tients with lymph node metastasis were higher than those in patients without lymph node metastasis (22.38± 2.57 U/ml and18.99± 2.15 U/ml, respectively; P<0.001). (4) The concentrations of CEA(30.72± 3.61 μ g/ml), CA199(92.22± 12.20 U/ml),and CA242 (68.08± 7.85 U/ml) in patients with distant metastasis were significantly higher than those in patients withoutdistant metastasis (9.83± 1.62 U/ml, 26.95± 2.27 U/ml, and 21.80± 1.80 U/ml, respectively; P<0.001). (5) Serum levels ofCEA, CA199, and CA242 increased as the Dukes stage elevated. (6) The serum CEA, CA199, and CA242 levels werepositively correlated with the depth of tumor invasion. (7) The serum levels of CA199 and CA242 in patients with invasivetype tumors were higher than those in patients with ulcerative, mushroom and cast type. (8) The size of the primary tumorwas closely related to the preoperative serum levels of CA199 and CA242. (9) The preoperative serum level of CEA has apositive correlation with the levels of serum CA199(r=0.189, P<0.05) and CA242(r=0.194, P<0.05). The CA199 level wassignificantly correlated with the CA242 level(r=0.884, P<0.001). Conclusion: (1) In colorectal cancer patients, the preop-erative serum levels of CEA, CA199, and CA242 were closely related to the location of the tumor and the presence ofdistant metastasis. (2) The preoperative serum levels of CA199 and CA242 showed a close relationship with clinical patho-logical characteristics. (3) Detection of preoperative serum levels of CEA, CA199, and CA242 can be helpful for evaluatingthe biological behaviors of colorectal cancer.

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