Huo Ya Ruth, Huang Yeqian, Liauw Winston, Zhao Jing, Morris David L
Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia Faculty of Medicine, St. George Clinical School, University of New South Wales, Sydney, NSW, Australia.
Cancer Care Centre, St. George Hospital, University of New South Wales, Sydney, NSW, Australia.
Anticancer Res. 2016 Mar;36(3):1041-9.
This study aimed to clarify the prognostic significance of tumour markers on long-term survival in colorectal peritoneal carcinomatosis (CRPC) following cytoreductive surgery and intraperitoneal chemotherapy.
Preoperative serum tumour markers of 164 patients with CRPC were analyzed. Peritoneal cancer index (PCI) was measured and relationship to survival calculated.
Carcinoembryonic antigen (CEA) >6.5 mg/l and cancer antigen 125 (CA125) >16 U/ml remained independent predictors of survival after adjusting for PCI [adjusted hazard ratio (aHR)=2.46, 95% confidence interval (CI)=1.3-4.5, p<0.01 and aHR=2.23, 95% CI=1.21-4.09, p<0.01, respectively]. Patients with high CEA and low CA125 or vice versa had an approximately triple risk of death (HR=3.34, 95% CI=1.21 9.25, p=0.02 and HR=2.76, 95% CI=1.01 7.77, p=0.04, respectively). High CEA with high CA125 produced an additive effect, reflecting a six-fold increase in death (HR=6.57, 95% CI=2.62 13.69, p<0.001, median survival: not reached vs. 22 months).
Serum CEA and CA125 in patients with CRPC treated with cytoreductive surgery and intraperitoneal chemotherapy convey a negative prognostic effect independently of PCI.
本研究旨在阐明肿瘤标志物对结直肠癌腹膜转移（CRPC）患者接受细胞减灭术和腹腔内化疗后长期生存的预后意义。
分析了164例CRPC患者的术前血清肿瘤标志物。测量腹膜癌指数（PCI）并计算其与生存的关系。
在校正PCI后，癌胚抗原（CEA）>6.5mg/L和癌抗原125（CA125）>16U/ml仍然是生存的独立预测因素[校正风险比（aHR）=2.46，95%置信区间（CI）=1.3 - 4.5，p<0.01；aHR=2.23，95%CI=1.21 - 4.09，p<0.01]。CEA高且CA125低或反之的患者死亡风险约增加两倍（HR=3.34，95%CI=1.21 - 9.25，p=0.02；HR=2.76，95%CI=1.01 - 7.77，p=0.04）。CEA高且CA125高产生相加效应，反映死亡风险增加六倍（HR=6.57，95%CI=2.62 - 13.69，p<0.001，中位生存期：未达到 vs. 22个月）。
接受细胞减灭术和腹腔内化疗的CRPC患者血清CEA和CA125独立于PCI具有负面预后效应。
