Mao Jie, Du Peng, Yang Han-Teng, Hu Huan, Wang Shi-Yao, Wu Xia, Cheng Zhi-Bin
The Department of General Surgery, Lanzhou University Second Hospital.
Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Medicine (Baltimore). 2020 Apr;99(14):e19420. doi: 10.1097/MD.0000000000019420.
The aim of this study is to evaluate the predictive value of carbohydrate antigen125 (CA125) and carcino embryonic antigen (CEA) expression and its guiding role of choosing chemotherapy regimen in post-operation patients with colorectal carcinoma.The clinical data of all patients, including laboratory data and pathological data, were collected from the electronic medical records. Kaplan-Meier Log rank test, COX regression model and subgroup analyses were employed to assess the correlation between the expression of CA125 and CEA in patients with colorectal carcinoma and the survival, and the effect on chemotherapy efficacy.Kaplan-Meier showed that CA125 expression is negatively related to the progression-free survival (PFS) of the post-operative patients, Median PFS was 1140 days in the patients with high expression, and Median PFS was 1387 days in the patients with low expression (χ = 4.715, P = .030); CEA expression is also negatively associated with the PFS of the post-operative patients, Median PFS was 1197 days in the patients with high expression, and Median PFS was 1424 days in the patients with low expression (χ = 4.992, P = .025). Subgroup analysis also showed that the patients with normal CA125 and CEA had better prognosis, median PFS was 1505 days, and the patients with CA125 and (or) CEA high expression had poor prognosis and median PFS was 1162 days (χ = 13.346, P = .001), and found that there was no statistical difference in patients with oxaliplatin plus capecitabine (XELOX) and oxaliplatin, 5-fluorouracil and Calcium folinate (FOLFOX) chemotherapy in patients with CA125 and CEA low expression. However, in these patients with CA125 or (and) CEA high expression, the median PFS of patients treated with XELOX was 1082 days, and the median PFS of patients treated with FOLFOX chemotherapy was 1335 (χ = 4.547, P = .033).Expression of CA125 and CEA associated with the survival of patients, and have some guiding significance for chemotherapy in patients with colorectal cancer after operation; Compared with XELOX, FOLFOX chemotherapy is more effective for CA125 or (and) CEA high expression patients with colorectal carcinoma.
本研究旨在评估糖类抗原125（CA125）和癌胚抗原（CEA）表达对结直肠癌术后患者的预测价值及其在化疗方案选择中的指导作用。所有患者的临床资料，包括实验室数据和病理数据，均从电子病历中收集。采用Kaplan-Meier Log秩检验、COX回归模型和亚组分析来评估结直肠癌患者CA125和CEA表达与生存之间的相关性，以及对化疗疗效的影响。Kaplan-Meier分析显示，CA125表达与术后患者的无进展生存期（PFS）呈负相关，高表达患者的中位PFS为1140天，低表达患者的中位PFS为1387天（χ=4.715，P=0.030）；CEA表达也与术后患者的PFS呈负相关，高表达患者的中位PFS为1197天，低表达患者的中位PFS为1424天（χ=4.992，P=0.025）。亚组分析还显示，CA125和CEA正常的患者预后较好，中位PFS为1505天，CA125和（或）CEA高表达的患者预后较差，中位PFS为1162天（χ=13.346，P=0.001），并且发现CA125和CEA低表达的患者接受奥沙利铂联合卡培他滨（XELOX）和奥沙利铂、5-氟尿嘧啶及亚叶酸钙（FOLFOX）化疗无统计学差异。然而，在这些CA125或（和）CEA高表达的患者中，可以发现接受XELOX治疗的患者中位PFS为1082天，接受FOLFOX化疗的患者中位PFS为1335天（χ=4.547，P=0.033）。CA125和CEA表达与患者生存相关，对结直肠癌术后患者化疗有一定指导意义；与XELOX相比，FOLFOX化疗对CA125或（和）CEA高表达的结直肠癌患者更有效。
