Lakemeyer Leilani, Sander Silvia, Wittau Mathias, Henne-Bruns Doris, Kornmann Marko, Lemke Johannes
Department of General and Visceral Surgery, University Hospital Ulm, 89081 Ulm, Germany.
Institute of Epidemiology and Medical Biometry, University of Ulm, 89081 Ulm, Germany.
Diseases. 2021 Mar 17;9(1):21. doi: 10.3390/diseases9010021.
Colorectal cancer (CRC) is the third most common cancer worldwide. A diagnosis at early stages with enhanced screening methods is vital as metastases and recurrences increase mortality. The aim of this study was to analyze the tumor markers CEA and CA19-9 combined in correlation with diagnostics and prognosis. Therefore, 1487 patients with CRC who were diagnosed and treated between 2000 and 2015 at the University Hospital Ulm, Germany, were retrospectively evaluated. Overall and recurrence-free survival was analyzed in association with preoperative CEA and CA19-9 separately and combined and a multivariate analysis was performed. The 5-year overall survival was significantly shorter in patients with a CEA or CA19-9 level ≥200 compared to patients with an increased, but <200, or normal level (CEA: 69%/44%/7%; CA19-9: 66%/38%/8%). Patients with both tumor markers increased also showed a remarkably shorter 5-year survival rate (CEA+/CA19-9+: 23%). The multivariate analysis emphasizes these results (-value < 0.0001). Patients with both tumor markers elevated had the shortest 5-year recurrence-free survival rate, followed by patients with either CEA or CA19-9 elevated (CEA-/CA19-9-: 79%; CEA+/CA19-9; CEA-/CA19-9+: 65%; CEA+/CA19-9+: 44%). In conclusion, measuring CEA and CA19-9 preoperatively in CRC patients is reasonable and could be useful as a prognostic factor.
结直肠癌（CRC）是全球第三大常见癌症。采用强化筛查方法在早期阶段进行诊断至关重要，因为转移和复发会增加死亡率。本研究的目的是分析肿瘤标志物癌胚抗原（CEA）和糖类抗原19-9（CA19-9）联合检测与诊断及预后的相关性。因此，对2000年至2015年期间在德国乌尔姆大学医院确诊并接受治疗的1487例CRC患者进行了回顾性评估。分别对术前CEA和CA19-9单独及联合检测与总生存期和无复发生存期进行了分析，并进行了多变量分析。与CEA或CA19-9水平≥200的患者相比，CEA或CA19-9水平升高但<200或正常的患者5年总生存期明显更长（CEA：69%/44%/7%；CA19-9：66%/38%/8%）。两种肿瘤标志物均升高的患者5年生存率也显著缩短（CEA+/CA19-9+：23%）。多变量分析强化了这些结果（P值<0.0001）。两种肿瘤标志物均升高的患者5年无复发生存期最短，其次是CEA或CA19-9升高的患者（CEA-/CA19-9-：79%；CEA+/CA19-9-；CEA-/CA19-9+：65%；CEA+/CA19-9+：44%）。总之，术前检测CRC患者的CEA和CA19-9是合理的，并且可能作为一种预后因素。
