术前CEA、CA19-9和CA50的表达水平与结直肠癌临床病理特点的相关性研究--附1 340例病例分析

目的分析手术前血清CEA、CA19-9和CA50在结直肠癌患者中的表达情况,研究其在不同肿瘤临床分期中的表达差异,及其与临床病理学特点的相关性。方法回顾分析2000年1月~2004年9月于肿瘤医院接受治疗的结直肠肿瘤病例1340例,术前采用放射免疫法测定血清CEA、CA19-9和CA50水平,术后综合术前影像学检查、术中探查结果和术后组织病理学检测进行临床分期,应用SPSS12.0统计软件进行相关性分析。结果在1340例患者中,有59例为外院手术后复发或者转移的患者,另外的1281例患者均为初治病例。其中结直肠癌患者1327例。CEA、CA19-9和CA50检测阳性率分别为25.9%、22.3%和22.8%,同手术性质(根治性/姑息性)和脉管侵犯等临床病理指标相关。CEA、CA19-9和CA50在不同肿瘤分期中表达差异显著,主要在D期患者和复发转移患者中出现高阳性率。CEA在粘液腺癌和腺癌组织中表达差异显著。三个指标的表达和患者性别无关。结论CEA、CA19-9及CA50和肿瘤的临床分期密切相关,其阳性表达提示合并淋巴结或者脏器转移可能,是预后不良指标。

The expression of tumor markers (CEA,CA19-9 and CA50) in colorectal neoplasm and its correlation with clinico-pathological characteristics: Analysis of 1 340 cases

Objective:To analyze the expression of preoperative CEA,CA19-9 and CA50 in the patients with colorectal neoplasm and explore its correlation with some clinico-pathological characteristics.Methods: 1 340 cases of colorectal neoplasm who received operation from Jan 2000 to Sep 2004 were collected and serum CEA,CA19-9,CA50 were tested by radioimmunal techniques. The correlation between expression of these tumor markers and clinico-pathological characteristics were analyzed. Statistic analysis was operated with SPSS 12.0 software package.Results:59 cases got treatments for recurrences, and 1 281 cases were operated for the primary diseases in our hospital with 1 327 cases of carcinoma. The positive rate of CEA,CA19-9 and CA50 was 25.9%,22.3%and 22.8% respectively. The expression showed correlation with some clinico-pathological characters such as features of operation (curative or palliative) and vascular invasion. Significant differences between Dukes' stages were found with high positive rate in the groups of Dukes' D stage and/or with recurrence and metastasis. CEA was highly expressed in the mucinous adenocarcinoma compared with adenocarcinoma. These markers had no relationship with sex of patients.Conclusion:the expression of CEA,CA19-9 and CA50 has close correlation with clinico-pathological stage. They are negative prognostic factors of colorectal carcinoma.