Tong Guojun, Wang Yanyan, Qian Hai, Tan Zhenhua, Shen Yan, Li Hui
Colorectal Surgery of Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China.
Central Laboratory of Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China.
Front Oncol. 2025 Jul 21;15:1590836. doi: 10.3389/fonc.2025.1590836. eCollection 2025.
To explore the effects of two combined methods-P53 expression and preoperative serum carcinoembryonic antigen (S-CEA) detection-on the prognosis of colorectal cancer (CRC).
Two classified combinations of tissue P53 and S-CEA were utilized: Combined P53 groups (normal P53 and S-CEA, or one or both elevated) and Recombined groups (P53 normal & S-CEA normal, P53 normal & S-CEA high, P53 high & S-CEA normal, P53 high & S-CEA high). Clinicopathologic features were analyzed by P53, S-CEA, Combined P53, and Recombined P53. Correlations between them were examined. Overall survival (OS) and disease-free survival (DFS) were evaluated using the Kaplan-Meier method and Log-Rank test. Univariate and multivariate analyses were performed for Combined P53 and Recombined P53 to determine independent factors. Three-year, two-year, and one-year OS and DFS were further analyzed using multimeROC. SPSS 27 and R 4.4.1 were used for analysis.
TNM stage, CA199, differentiation, tumor maximum size, and minimum size showed significant differences between the single P53 and S-CEA groups (all P < 0.05). TNM stage, CA199, and chemotherapy differed in both Combined P53 and Recombined P53 groups (all P < 0.05). Significant correlations were found between P53, S-CEA, Combined P53, and Recombined P53 (all P < 0.001). No significant differences in OS and DFS were observed with P53 and Combined P53 (all P > 0.05), but differences were noted with S-CEA and Recombined P53 (all P < 0.05). Univariate and multivariate analyses identified laparoscopy, chemotherapy, differentiation, TNM stage, and Recombined P53 as independent factors for OS and DFS, while P53, S-CEA, and Combined P53 were not. Further multimeROC analysis showed that 3-year OS had better sensitivity and specificity (Area Under Curve [AUC] = 0.54), and 1-year DFS was better (AUC = 0.59).
Recombined P53 classification was more effective than traditional Combined P53 classification for assessing CRC prognosis and was an independent factor. Additionally, the 3-year OS and 1-year DFS analysis demonstrated higher sensitivity and specificity with Recombined P53.
探讨P53表达与术前血清癌胚抗原（S-CEA）检测这两种联合方法对结直肠癌（CRC）预后的影响。
采用组织P53和S-CEA的两种分类组合：联合P53组（正常P53和S-CEA，或一项或两项升高）和重组组（P53正常&S-CEA正常、P53正常&S-CEA高、P53高&S-CEA正常、P53高&S-CEA高）。通过P53、S-CEA、联合P53和重组P53分析临床病理特征。检查它们之间的相关性。采用Kaplan-Meier法和Log-Rank检验评估总生存期（OS）和无病生存期（DFS）。对联合P53和重组P53进行单因素和多因素分析以确定独立因素。使用多变量受试者工作特征曲线（multimeROC）进一步分析三年、两年和一年的OS和DFS。使用SPSS 27和R 4.4.1进行分析。
单因素P53组和S-CEA组之间的TNM分期、CA199、分化程度、肿瘤最大径和最小径显示出显著差异（均P<0.05）。联合P53组和重组P53组的TNM分期、CA199和化疗情况均有差异（均P<0.05）。P53、S-CEA、联合P53和重组P53之间存在显著相关性（均P<0.001）。P53和联合P53在OS和DFS方面未观察到显著差异（均P>0.05），但S-CEA和重组P53存在差异（均P<0.05）。单因素和多因素分析确定腹腔镜检查、化疗、分化程度、TNM分期和重组P53是OS和DFS的独立因素，而P53、S-CEA和联合P53不是。进一步的多变量受试者工作特征曲线分析表明，三年OS具有更好的敏感性和特异性（曲线下面积[AUC]=0.54），一年DFS更好（AUC=0.59）。
在评估CRC预后方面，重组P53分类比传统的联合P53分类更有效，且是一个独立因素。此外，重组P53的三年OS和一年DFS分析显示出更高的敏感性和特异性。
