Kuang Jiaan, Gong Yizhen, Xie Hailun, Yan Ling, Huang Shizhen, Gao Feng, Tang Shuangyi, Gan Jialiang
Department of Colorectal Anal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
PeerJ. 2020 Apr 14;8:e8936. doi: 10.7717/peerj.8936. eCollection 2020.
There had been no recognized serum tumor marker to predict the prognosis of colorectal cancer (CRC) patients with normal preoperative serum carcinoembryonic antigen (CEA) levels. The purpose of this study was to determine whether preoperative serum carbohydrate antigen 724 (CA724) was of predictive function for the prognosis of CRC patients with normal CEA levels.
The medical records of 295 CRC patients with normal CEA levels who underwent surgery at the Department of Colorectal Anal Surgery of the First Affiliated Hospital of Guangxi Medical University (Guangxi, China) between September 2012 and September 2014 were retrospectively reviewed. The Chi-square test was used to test the correlation between preoperative serum CA724 levels and clinical features. Kaplan-Meier curves were conducted to calculate the overall survival (OS) rate and disease-free survival (DFS) of patients. Cox regression analysis was applied to conduct univariate and multivariate analysis of the following four preoperative serum tumor makers namely CA724, carbohydrate antigen 199 (CA199), carcinoembryonic antigen 125 (CA125), carcinoembryonic antigen 242 (CA242) and clinical features. Nomograms for prognostic parameter of OS and DFS were developed using R v3.2.5.
In the Chi-square test, only pathological node stage (pN stage) ( = 14.514, = 0.001) and differentiation ( = 10.712, = 0.001) were associated with serum CA724 levels. In the Kaplan-Meier analysis, the results revealed that the OS and DFS in patients with high CA724 was poorer than those with normal. In the multivariate Cox regression analysis of OS and DFS, only pT stage, pN stage, metastasis and serum CA724 were independent prognostic risk factors for CRC patients with normal CEA levels.
Preoperative serum CA724 might serve as a potential prognostic factor for CRC patients with normal serum CEA levels.
对于术前血清癌胚抗原（CEA）水平正常的结直肠癌（CRC）患者，尚无公认的血清肿瘤标志物可用于预测其预后。本研究旨在确定术前血清糖类抗原724（CA724）对CEA水平正常的CRC患者预后是否具有预测作用。
回顾性分析2012年9月至2014年9月在广西医科大学第一附属医院（中国广西）结直肠肛门外科接受手术的295例CEA水平正常的CRC患者的病历。采用卡方检验来检验术前血清CA724水平与临床特征之间的相关性。绘制Kaplan-Meier曲线以计算患者的总生存期（OS）率和无病生存期（DFS）。应用Cox回归分析对以下四种术前血清肿瘤标志物，即CA724、糖类抗原199（CA199）、癌胚抗原125（CA125）、癌胚抗原242（CA242）以及临床特征进行单因素和多因素分析。使用R v3.2.5软件绘制OS和DFS预后参数的列线图。
在卡方检验中，仅病理淋巴结分期（pN分期）（ = 14.514， = 0.001）和分化程度（ = 10.712， = 0.001）与血清CA724水平相关。在Kaplan-Meier分析中，结果显示CA724水平高的患者的OS和DFS比CA724水平正常的患者差。在OS和DFS的多因素Cox回归分析中，对于CEA水平正常的CRC患者，仅pT分期、pN分期、转移情况和血清CA724是独立的预后危险因素。
术前血清CA724可能是血清CEA水平正常的CRC患者的潜在预后因素。
