III期结直肠癌患者术前CRP（-）/CEA（-）/CA19-9（-）/非T4是复发的有利风险因素。
Preoperative CRP(-)/CEA(-)/CA19-9(-)/non-T4 in Stage III Colorectal Cancer Is Favorable Risk for Recurrence.
作者信息
Ushigome Mitsunori, Shimada Hideaki, Kaneko Tomoaki, Miura Yasuyuki, Nagashima Yasuo, Suzuki Takayuki, Kagami Satoru, Kurihara Akiharu, Funahashi Kimihiko
机构信息
Department of Surgery, Toho University School of Medicine, Tokyo, Japan.
出版信息
J Anus Rectum Colon. 2022 Oct 27;6(4):264-273. doi: 10.23922/jarc.2022-010. eCollection 2022.
OBJECTIVES
We evaluated the prognostic impact of a novel C-reactive protein (CRP) cut-off value (0.6 mg/dl) and carcinoembryonic antigen (CEA)/carbohydrate antigen 19-9 (CA19-9) in stage II/III colorectal cancer.
METHODS
Four hundred ninety-eight patients with stage II (n = 275) or stage III (n = 223) colorectal cancer, surgically treated between January 2010 and December 2016, were analyzed. The optimal CRP cut-off value was fixed at 0.6 mg/dl to predict recurrence based on the receiver operating characteristic curve. Prognostic factors, including CRP/CEA/CA19-9 status, for relapse-free survival (RFS) were evaluated by multivariate analysis.
RESULTS
Recurrent rates were 15% and 32% in stages II and III, respectively. In stage II, CRP, CEA, and CA19-9 were not significant prognostic factors for RFS. In stage III, the RFS of the low CRP group was significantly better than that of the high CRP group ( = 0.002). In stage III, the RFS of CRP(-)/CEA(-) or CRP(-)/CA19-9(-) was significantly better than the other group, as opposed to the RFS of the CEA(-)/CA19-9(-) group that was not. The CRP(-)/CEA(-)/CA19-9(-) group recurrence rate in stage III was significantly better than the CRP(+)/CEA(-)/CA19-9(-) group (20% vs. 50%, = 0.006). Multivariate analysis revealed that CRP(-)/CEA(-)/CA19-9(-) ( = 0.04) and non-T4 ( < 0.001) were good independent prognostic factors in stage III. The CRP(-)/CEA(-)/CA19-9(-)/non-T4 group recurrence rate in stage III was 11% (8 out of 73).
CONCLUSIONS
In stage III, the CRP(-)/CEA(-)/CA19-9(-)/non-T4 group is favorable risk for recurrence.
目的
我们评估了一种新型C反应蛋白（CRP）临界值（0.6mg/dl）以及癌胚抗原（CEA）/糖类抗原19-9（CA19-9）对II/III期结直肠癌的预后影响。
方法
分析了2010年1月至2016年12月期间接受手术治疗的498例II期（n = 275）或III期（n = 223）结直肠癌患者。根据受试者工作特征曲线，将最佳CRP临界值设定为0.6mg/dl以预测复发。通过多因素分析评估包括CRP/CEA/CA19-9状态在内的无复发生存期（RFS）的预后因素。
结果
II期和III期的复发率分别为15%和32%。在II期，CRP、CEA和CA19-9不是RFS的显著预后因素。在III期，低CRP组的RFS显著优于高CRP组（P = 0.002）。在III期，CRP（-）/CEA（-）或CRP（-）/CA19-9（-）组的RFS显著优于另一组，而CEA（-）/CA19-9（-）组则不然。III期CRP（-）/CEA（-）/CA19-9（-）组的复发率显著低于CRP（+）/CEA（-）/CA19-9（-）组（20%对50%，P = 0.006）。多因素分析显示，CRP（-）/CEA（-）/CA19-9（-）（P = 0.04）和非T4期（P < 0.001）是III期良好的独立预后因素。III期CRP（-）/CEA（-）/CA19-9（-）/非T4期组的复发率为11%（73例中有8例）。
结论
在III期，CRP（-）/CEA（-）/CA19-9（-）/非T4期组复发风险较低。
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