Zhang Di, Yu Mingxia, Xu Tangpeng, Xiong Bin
Hepatogastroenterology. 2013 Sep;60(126):1297-301. doi: 10.5754/hge121125.
BACKGROUND/AIMS: Liver metastases are associated with poor prognosis in patients with colorectal cancer (CRC). The objective of this study is to determine the possible indicators in identifying the predictive value of serum CEA, CA19-9 and CA-125 in diagnosis of liver metastases from CRC in the Chinese population.
We randomly selected 101 CRC patients with liver metastases and 81 patients without liver metastases. Several clinical pathological factors were analyzed for the correlation with liver metastases. The predictive value of CEA, CA19-9 and CA-125 for liver metastases from CRC was evaluated.
There was no significant difference in gender, age, hepatitis B history, serum AFP level or lesion location. Patients with liver metastases had a tendency to have higher serum CEA, CA19-9 and CA-125 level. Multivariate analysis revealed that serum CEA level (p<0.001), CA19-9 level (p<0.001) and CA-125 level (p=0.001) were independent prognostic predictors for liver metastases. Combination of CEA, CA19-9 and CA-125 can enhance their sensitivity in diagnosis of synchronous and metachronous liver metastases. Serum CA19-9 level, combined test of CA19-9 and CA-125, combined test of triple markers have higher sensitivities in synchronous metastasis than those in metachronous metastasis.
Combination test would enhance the sensitivities of serum CEA, CA19-9 and CA-125 levels, which are important in predicting liver metastases from CRC in the Chinese population, either synchronous or metachronous.
背景/目的:肝转移与结直肠癌(CRC)患者的不良预后相关。本研究的目的是确定在中国人群中识别血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)和糖类抗原125(CA-125)对CRC肝转移诊断预测价值的可能指标。
我们随机选取了101例发生肝转移的CRC患者和81例未发生肝转移的患者。分析了几种临床病理因素与肝转移的相关性。评估了CEA、CA19-9和CA-125对CRC肝转移的预测价值。
在性别、年龄、乙肝病史、血清甲胎蛋白水平或病变部位方面无显著差异。发生肝转移的患者血清CEA、CA19-9和CA-125水平有升高趋势。多因素分析显示,血清CEA水平(p<0.001)、CA19-9水平(p<0.001)和CA-125水平(p=0.001)是肝转移的独立预后预测指标。CEA、CA19-9和CA-125联合检测可提高其对同时性和异时性肝转移的诊断敏感性。血清CA19-9水平、CA19-9与CA-125联合检测、三项指标联合检测对同时性转移的敏感性高于异时性转移。
联合检测可提高血清CEA、CA19-9和CA-125水平的敏感性,这对预测中国人群中CRC的肝转移(无论是同时性还是异时性)具有重要意义。