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结直肠癌肝转移灶切除术后第一个月癌胚抗原的动态评估作为快速复发预测指标

Dynamic assessment of carcinoembryonic antigen in the first month after liver resection for colorectal liver metastases as a rapid-recurrence predictor.

作者信息

Takamoto Takeshi, Sugawara Yasuhiko, Hashimoto Takuya, Shimada Kei, Inoue Kazuto, Maruyama Yoshikazu, Makuuchi Masatoshi

机构信息

Divisions of Hepato-Biliary-Pancreatic and Liver Transplantation, Japanese Red Cross Medical Center, Tokyo, Japan.

出版信息

J Surg Oncol. 2016 Mar;113(4):463-8. doi: 10.1002/jso.24152. Epub 2016 Jan 12.

Abstract

BACKGROUND

Carcinoembryonic antigen (CEA) is a tumor marker used widely for detecting the recurrence and predicting the prognosis of colorectal cancer. This study investigates the possibility of serial measurement of serum CEA in several weeks after liver resection for colorectal liver metastases (CRLM) in detecting earlier detection of recurrence.

METHODS

From 2007 to 2014, CEA levels were assessed at 1 week and at 2-3 weeks after curative-intent liver resection among a total of 240 patients with CRLM. The CEA half-life was calculated and patients were divided into two groups: those with a CEA half-life ≤10 days or normalized (Group S), and those with a CEA half-life >10 days or rising (Group L).

RESULTS

The 1-, 3-, and 5-year overall survival rates in Group S versus Group L were 91.3% versus 83.3%, 64.0% versus 41.3%, and 44.2% versus 29.3%, respectively (P = 0.0079). Multivariate analysis revealed that resection of extrahepatic lesions, four or more lesions of liver metastases, and categorization in Group L were independent factors of rapid recurrence within 100 days.

CONCLUSION

A CEA half-life >10 days or rising 1 month after curative-intent liver resection was associated with rapid recurrence of CRLM within 100 days. J. Surg. Oncol. 2016;113:463-468. © 2016 Wiley Periodicals, Inc.

摘要

背景

癌胚抗原(CEA)是一种广泛用于检测结直肠癌复发和预测预后的肿瘤标志物。本研究探讨了在结直肠癌肝转移(CRLM)肝切除术后数周内连续检测血清CEA以更早发现复发的可能性。

方法

2007年至2014年,对240例CRLM患者在根治性肝切除术后1周以及2 - 3周评估CEA水平。计算CEA半衰期,并将患者分为两组:CEA半衰期≤10天或恢复正常的患者(S组),以及CEA半衰期>10天或升高的患者(L组)。

结果

S组与L组的1年、3年和5年总生存率分别为91.3%对83.3%、64.0%对41.3%、44.2%对29.3%(P = 0.0079)。多因素分析显示,肝外病变切除、肝转移灶4个或更多以及属于L组是100天内快速复发的独立因素。

结论

根治性肝切除术后CEA半衰期>10天或1个月内升高与CRLM在100天内快速复发相关。《外科肿瘤学杂志》2016年;113:463 - 468。© 2016威利期刊公司

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