Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu, China.
Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu, China.
Cancer Biomark. 2018;22(1):161-168. doi: 10.3233/CBM-181179.
BACKGROUND: Adjuvant chemotherapy plays important role in the comprehensive treatment of patients with stage III colorectal cancer. However, there is few molecular markers for predicting the therapeutic effect. OBJECTIVE: To identify factors that could predict adjuvant chemotherapy benefits in patients with stage III colorectal cancer. METHODS: The medical records of 294 patients were reviewed and analyzed using the Kaplan-Meier method and Cox analysis. RESULTS: Lower CA125 (⩽ 35 u/ml, P= 0.0015) serum levels, stage IIIa (P= 0.0027), 1-3 positive lymph nodes (P= 0.0256), negative vascular invasion (P= 0.0215), lower CA199 (⩽ 27 u/ml, P= 0.0038) serum levels, and wild-type BRAF status (P= 0.0125) were significantly associated with a higher 2-year DFS rate in patients with stage III colorectal cancer. However, in multivariate COX analysis, the association remained significant only for CA125 levels (vs. ⩽ 35 u/ml group, HR 3.341; 95% CI, 1.198-9.316; P= 0.0212), vascular invasion (vs. negative vascular invasion, HR, 2.349; 95% CI, 1.227-4.499; P= 0.01), and BRAF (V600E) (vs. wild Braf, HR, 7.794; 95% CI, 1.867-32.531; P= 0.0049). CONCLUSION: Lower CA125 serum levels, negative vascular invasion, and wild-type BRAF status were significantly associated with improved 2-year DFS rates among patient with stage III disease who received adjuvant chemotherapy.
背景:辅助化疗在 III 期结直肠癌患者的综合治疗中发挥着重要作用。然而,目前预测治疗效果的分子标志物还很少。
目的:确定可预测 III 期结直肠癌患者辅助化疗获益的因素。
方法:回顾性分析 294 例患者的病历资料,采用 Kaplan-Meier 法和 Cox 分析。
结果:较低的 CA125(⩽35u/ml,P=0.0015)血清水平、IIIa 期(P=0.0027)、1-3 个阳性淋巴结(P=0.0256)、无血管侵犯(P=0.0215)、较低的 CA199(⩽27u/ml,P=0.0038)血清水平和野生型 BRAF 状态(P=0.0125)与 III 期结直肠癌患者较高的 2 年无病生存率显著相关。然而,在多变量 COX 分析中,CA125 水平(与 ⩽35u/ml 组相比,HR=3.341;95%CI,1.198-9.316;P=0.0212)、血管侵犯(与无血管侵犯相比,HR=2.349;95%CI,1.227-4.499;P=0.01)和 BRAF(V600E)(与野生型 BRAF 相比,HR=7.794;95%CI,1.867-32.531;P=0.0049)与 2 年无病生存率的相关性仍具有统计学意义。
结论:对于接受辅助化疗的 III 期疾病患者,较低的 CA125 血清水平、无血管侵犯和野生型 BRAF 状态与改善 2 年无病生存率显著相关。
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