Department of Surgery, Toho University School of Medicine, Tokyo, Japan.
Department of Gastroenterological Surgery and Clinical Oncology, Graduate School of Medicine, Toho University, Tokyo, Japan.
J Gastrointest Cancer. 2024 Sep;55(3):1212-1219. doi: 10.1007/s12029-024-01069-9. Epub 2024 Jun 13.
This study aimed to evaluate the clinicopathological and prognostic significance of preoperative serum creatine kinase (CK) levels in colorectal cancer.
This study analyzed 1169 patients with colorectal cancer at stages 0 (n = 35), I (n = 301), II (n = 456), III (n = 339), and IV (n = 38). The CK cut-off value was 52 U/L to predict recurrence based on receiver operative characteristics curve. Clinicopathological factors were compared between the low (< 52 U/L) and high CK groups (≥ 52 U/L). The multivariate analysis evaluated relapse-free survival (RFS) and overall survival (OS) following CK status.
The female sex, elderly age (≥ 75), deep tumor (pT4), and carcinoembryonic antigen (+) were independently associated with low CK status. The recurrent rate was significantly higher in the low CK group than in the high CK group (19.1% vs. 11.7%, p < 0.001). Elderly age, pT4, pN (+), preoperative carbohydrate antigen (CA) 19-9 (+), and low CK status were independent risk factors for RFS. Elderly age, pT4, pN (+), preoperative CA19-9 (+), and low CK status were independent risk factors for OS.
Preoperative low CK status was associated with deep tumors and was a poor prognostic factor in patients with colorectal cancer.
本研究旨在评估术前血清肌酸激酶（CK）水平在结直肠癌中的临床病理和预后意义。
本研究分析了 1169 例 0 期（n=35）、I 期（n=301）、II 期（n=456）、III 期（n=339）和 IV 期（n=38）的结直肠癌患者。根据接受者操作特征曲线，将 CK 截断值设定为 52 U/L 以预测复发。比较低（<52 U/L）和高 CK 组（≥52 U/L）之间的临床病理因素。多变量分析评估 CK 状态后无复发生存（RFS）和总生存（OS）。
女性、老年（≥75 岁）、肿瘤较深（pT4）和癌胚抗原（CEA）阳性与低 CK 状态独立相关。低 CK 组的复发率明显高于高 CK 组（19.1% vs. 11.7%，p<0.001）。老年、pT4、pN（+）、术前糖类抗原（CA）19-9（+）和低 CK 状态是 RFS 的独立危险因素。老年、pT4、pN（+）、术前 CA19-9（+）和低 CK 状态是 OS 的独立危险因素。
术前低 CK 状态与肿瘤较深有关，是结直肠癌患者预后不良的因素。
