Zhu Tianyi, Li Yunsong, Li Rui, Zhang Jingjing, Zhang Wentao
Department of Clinical Laboratory, The Third Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China.
Department of General Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China.
Medicine (Baltimore). 2025 Jan 10;104(2):e41264. doi: 10.1097/MD.0000000000041264.
Colorectal cancer is one of the most common malignant tumors in the world, and about 50% of its advanced patients will have liver metastasis. Preoperative assessment of the risk of liver metastasis in patients with colorectal cancer is of great significance for making individualized treatment plans. Traditional imaging examinations and tumor markers have some limitations in predicting the risk of liver metastasis. Therefore, it is of great clinical value to explore more sensitive and specific predictive indicators for improving early detection and treatment effect. In recent years, circulating tumor cells (CTCs), as a new biomarker, have attracted much attention because of their close relationship with tumor metastasis and prognosis. The purpose of this study is to collect and analyze the data of colorectal cancer patients treated in our hospital, so as to determine the predictive value of circulating tumor cells before operation and related hematological indexes for liver metastasis after radical resection of colorectal cancer, and to establish the corresponding prediction model to provide gastrointestinal surgeons with more accurate identification of high-risk patients and guidance for treatment. A total of 88 patients were included in this study, and 26 of whom developed liver metastasis after colorectal cancer surgery. The possible related factors are included in the single factor logistic regression, and the results are obtained after analysis. Body mass index, carcinoembryonic antigen (CEA), carbohydrate antigen 19-9, tumor marker CA72-4 (CA72-4), cytokeratin-7 (CK-7), CTC count, and neutrophil-to-lymphocyte ratio (P < .2) are risk factors for liver metastasis after radical resection of colorectal cancer. Furthermore, the data obtained were included in multivariate regression analysis, and CEA, CA72-4, CK-7, and CTC counts were independent risk factors for liver metastasis after radical resection of colorectal cancer (P < .05). This study confirmed that CEA, CA72-4, CK-7, and CTC counts are independent risk factors for liver metastasis after radical resection of colorectal cancer. In addition, the prediction model of this study can help gastrointestinal surgeons accurately identify patients who are prone to liver metastasis after colorectal cancer surgery.
结直肠癌是世界上最常见的恶性肿瘤之一,约50%的晚期患者会发生肝转移。对结直肠癌患者肝转移风险进行术前评估,对于制定个体化治疗方案具有重要意义。传统的影像学检查和肿瘤标志物在预测肝转移风险方面存在一定局限性。因此,探索更敏感、特异的预测指标以提高早期诊断和治疗效果具有重要的临床价值。近年来,循环肿瘤细胞(CTCs)作为一种新型生物标志物,因其与肿瘤转移和预后密切相关而备受关注。本研究旨在收集并分析我院收治的结直肠癌患者的数据,以确定术前循环肿瘤细胞及相关血液学指标对结直肠癌根治术后肝转移的预测价值,并建立相应的预测模型,为胃肠外科医生更准确地识别高危患者及指导治疗提供依据。本研究共纳入88例患者,其中26例在结直肠癌手术后发生肝转移。将可能的相关因素纳入单因素logistic回归分析,分析后得出结果。体重指数、癌胚抗原(CEA)、糖类抗原19-9、肿瘤标志物CA72-4(CA72-4)、细胞角蛋白-7(CK-7)、循环肿瘤细胞计数及中性粒细胞与淋巴细胞比值(P < 0.2)是结直肠癌根治术后肝转移的危险因素。此外,将所得数据纳入多因素回归分析,结果显示CEA、CA72-4、CK-7及循环肿瘤细胞计数是结直肠癌根治术后肝转移的独立危险因素(P < 0.05)。本研究证实,CEA、CA72-4、CK-7及循环肿瘤细胞计数是结直肠癌根治术后肝转移的独立危险因素。此外,本研究的预测模型有助于胃肠外科医生准确识别结直肠癌手术后易发生肝转移的患者。