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结直肠癌肝转移患者的血清学诊断因素。

Serological diagnostic factors for liver metastasis in patients with colorectal cancer.

机构信息

Department of Zhong-Shan-Men In-patient, Cancer Institute and Hospital, Tianjin Medical University, Jintang Road, Hedong District, Tianjin, China.

出版信息

World J Gastroenterol. 2010 Aug 28;16(32):4084-8. doi: 10.3748/wjg.v16.i32.4084.

Abstract

AIM

To investigate the serological diagnostic factors for liver metastasis in patients with colorectal cancer.

METHODS

One hundred and six adult in-patients with colorectal cancer were studied and divided into patients with liver metastasis (n = 56) and patients without liver metastasis (n = 50). Serum levels of tumor and biochemical markers for liver were measured at the time of diagnosis.

RESULTS

The mean survival time was 55.9 mo, 36.8 mo and 68.3 mo for the overall patients, patients with liver metastasis and patients without liver metastasis, respectively. Lactate dehydrogenase (LDH) level was significantly correlated with the survival time of colorectal cancer patients. The levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase (GGT), LDH and carcinoembryonic antigen (CEA) were significantly higher in patients with liver metastasis than in those without liver metastasis. Patients with lymph node metastasis had a higher risk of liver metastasis than those without lymph node metastasis. The cut points of LDH, GGT and CEA for screening liver metastasis were 180 U/L, 30 U/L and 5.0 microg/L, respectively. The sensitivity was 64.3%, 69.6% and 70.4%, and the specificity was 64.0%, 60.0% and 52.4%, respectively. The sensitivity of parallel test was 85.2% for LDH and CEA, and 92.6% for GGT and CEA, respectively. The specificity of serial test was 85.7% for LDH (or GGT) and CEA.

CONCLUSION

Early diagnosis of liver metastasis is of great significance. The sensitivity and specificity of combined tumor and biochemical markers are rather good in screening colorectal liver metastasis.

摘要

目的

探讨结直肠癌患者肝转移的血清学诊断因素。

方法

研究了 106 例成年住院结直肠癌患者,将其分为肝转移患者(n=56)和无肝转移患者(n=50)。在诊断时测量了肿瘤和肝功能生化标志物的血清水平。

结果

总的患者、有肝转移的患者和无肝转移的患者的平均生存时间分别为 55.9、36.8 和 68.3 个月。乳酸脱氢酶(LDH)水平与结直肠癌患者的生存时间显著相关。有肝转移的患者的丙氨酸氨基转移酶、天冬氨酸氨基转移酶、γ-谷氨酰转移酶(GGT)、LDH 和癌胚抗原(CEA)水平显著高于无肝转移的患者。有淋巴结转移的患者比无淋巴结转移的患者有更高的肝转移风险。用于筛查肝转移的 LDH、GGT 和 CEA 的切点分别为 180 U/L、30 U/L 和 5.0μg/L。其灵敏度分别为 64.3%、69.6%和 70.4%,特异性分别为 64.0%、60.0%和 52.4%。LDH 和 CEA 的并联试验的灵敏度为 85.2%,GGT 和 CEA 的并联试验的灵敏度为 92.6%。LDH(或 GGT)和 CEA 的串联试验的特异性为 85.7%。

结论

早期诊断肝转移具有重要意义。联合肿瘤和生化标志物筛查结直肠癌肝转移的灵敏度和特异性均较好。

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