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腹腔镜根治性切除结直肠癌患者的胃肠功能分析及肿瘤标志物的预后价值

Analysis of gastrointestinal function and prognostic value of tumor markers in patients with laparoscopic radical resection of colorectal cancer.

作者信息

Luo Yezhe, Lu Yizhuo, Kuang Penghao, Huang Qinghe, Huang Yanqin, Xiong Boliang, Chen Qinggui

机构信息

Department of General Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen 361004, Fujian Province, China.

Department of Central Intensive Care Unit, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen 361004, Fujian Province, China.

出版信息

Am J Transl Res. 2022 Sep 15;14(9):6618-6626. eCollection 2022.

Abstract

OBJECTIVE

To analyze the gastrointestinal function and prognostic value of tumor markers (TMs) in patients with laparoscopic radical resection of colorectal cancer (LRRCC).

METHODS

The research population of this retrospective study comprised 141 patients with CC who received treatment in the Zhongshan Hospital of Xiamen University between July 2017 and August 2018, including 74 cases (observation group, OG) treated with LRRCC and 67 cases (control group, CG) undergoing open surgery (OS). Postoperative gastrointestinal function and complications were recorded. Besides, alterations in serum TMs carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), and the 3-years survival of patients were observed. Receiver operating characteristic (ROC) curves were used to determine the prognostic value of TMs. Risk factors affecting the prognosis of LRRCC patients were analyzed by the Cox regression model.

RESULTS

Significantly higher levels of motilin (MOT) and gastrin (GT) were determined in OG compared with CG. The two groups showed no notable difference in the postoperative complication rate. Postoperative serum CEA and CA199 levels were obviously lower in OG as compared with CG. A higher 3-year survival rate was determined in OG. The areas under the receiver operating characteristic (ROC) curve (AUCs) of CEA and CA19-9 levels in predicting patients' 3-year survival were 0.826 and 0.867, respectively. According to the Cox regression analysis, tumor diameter, lymph node involvement, TNM staging, vascular invasion, CEA, and CA19-9 were independent risk factors for poor prognosis of LRRCC patients.

CONCLUSIONS

LRRCC is well-tolerated by patients with CC and contributes to favorable outcomes. Besides, CEA and CA19-9, the two TMs, may be candidate prognostic markers for patients undergoing LRRCC.

摘要

目的

分析腹腔镜结直肠癌根治术(LRRCC)患者的胃肠功能及肿瘤标志物(TMs)的预后价值。

方法

本回顾性研究的研究对象为2017年7月至2018年8月在厦门大学附属中山医院接受治疗的141例结肠癌患者,其中74例接受LRRCC治疗(观察组,OG),67例接受开放手术(OS)(对照组,CG)。记录术后胃肠功能及并发症情况。此外,观察血清TMs癌胚抗原(CEA)和糖类抗原19-9(CA19-9)的变化以及患者的3年生存率。采用受试者工作特征(ROC)曲线确定TMs的预后价值。通过Cox回归模型分析影响LRRCC患者预后的危险因素。

结果

与CG相比,OG中胃动素(MOT)和胃泌素(GT)水平显著更高。两组术后并发症发生率无显著差异。与CG相比,OG术后血清CEA和CA199水平明显更低。OG的3年生存率更高。CEA和CA19-9水平预测患者3年生存率的受试者工作特征(ROC)曲线下面积(AUCs)分别为0.826和0.867。根据Cox回归分析,肿瘤直径、淋巴结受累情况、TNM分期、血管侵犯、CEA和CA19-9是LRRCC患者预后不良的独立危险因素。

结论

CC患者对LRRCC耐受性良好,且有助于获得良好预后。此外,CEA和CA19-9这两种TMs可能是LRRCC患者的候选预后标志物。

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