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    田赟. 结直肠癌患者术前血清学指标肿瘤标志物研究[J]. 徐州医科大学学报, 2021, 41(2): 113-118. DOI: 10.3969/j.issn.2096-3882.2021.02.007
    引用本文: 田赟. 结直肠癌患者术前血清学指标肿瘤标志物研究[J]. 徐州医科大学学报, 2021, 41(2): 113-118. DOI: 10.3969/j.issn.2096-3882.2021.02.007
    shu
    The association between preoperative routine blood tests and postoperative tumor characteristics in patients with colorectal cancer[J]. Journal of Xuzhou Medical University, 2021, 41(2): 113-118. DOI: 10.3969/j.issn.2096-3882.2021.02.007
    Citation: The association between preoperative routine blood tests and postoperative tumor characteristics in patients with colorectal cancer[J]. Journal of Xuzhou Medical University, 2021, 41(2): 113-118. DOI: 10.3969/j.issn.2096-3882.2021.02.007
    shu

    结直肠癌患者术前血清学指标肿瘤标志物研究

    The association between preoperative routine blood tests and postoperative tumor characteristics in patients with colorectal cancer

      摘要
    • 摘要: 目的 结直肠癌colorectal cancer, CRC)患者就诊时常伴肿瘤标志物升高、贫血、低蛋白血症等血清学变化并提示预后不良，旨大样本系统性评估RC术前常规血液学检查和肿瘤大小、转移情况、分期等关系。方法 收集2009年12月—2017年9月间医院932例手术RC患者临床数据，患者术前一周临床血液学检查数据，利用SPSS分析软件，、白蛋白、CEA、CA199与肿瘤大小、淋巴结转移、远处转移、TNM分期组织分级的关系。结果 932例患者中男性538例，直肠癌593例，年龄分布24-89岁，平均年龄61.89±11.98年，中位年龄63岁。T3和T4期患者相较于早期T0-2期患者，CEA(P0.01)、CA199(P＜0.01)中性粒细胞(P=0.03)升高；淋巴细胞(P=0.03)血红蛋白(P=0.001)降低。相较于未转移患者有淋巴结转移的病例术前外周血CEA(P=0.001)CA199(P=0.002)升高。发生远处转移的患者较未转移患者白细胞(P=0.014)、中性粒细胞(P=0.001)CEA(P=0.02)升高。OC曲线分析术前、CEA、CA199拟合曲线T3和T4的敏感性为86.5 %，特异性为49.1%；术前CEA、CA199拟合曲线淋巴结转移的敏感性为67.4 %，特异性为56.7%；术前CEA、CA199拟合曲线远处转移的敏感性为88.9%，特异性为24.8%。结论RC患者术前与术后肿瘤大小、淋巴结和远处转移、TNM分期等影响患者远期预后的因素存在一定相关性，。

       

      Abstract: obective Colorectal cancer (CRC) patients are often accompanied by changes of serological such as elevated tumor markers, anemia, and hypoproteinemia which may be associated with a poor prognosis. This study aims to systematically evaluate the relationship between preoperative parameters of routine blood tests and tumor size, metastasis and stage by using a large sample size of patients with CRC. Methods Information of 932 patients with CRC undergoing surgery in tertiary hospital from December 2009 to September 2017 were enrolled, and the routine blood tests data and serum tumor markers in a week before the operation were collected. SPSS software was used to analyze the relationship between systemic inflammation, albumin, CEA, and CA199 and tumor size, lymph node metastasis, distant metastasis, TNM stage, and histopathological grade. Results Among the 932 patients, there were 538 males and 593 rectal cancers cases. The age ranged from 24 to 89 years, with an average age of 61.89±11.98 years and a median age of 63 years. Compared with early T0-2 patients, T3 and T4 patients had higher levels of CEA (P<0.01), CA199 (P<0.01) and neutrophils (P=0.03); whereas lymphocytes (P=0.03) and hemoglobin (P=0.001) decreased. Compared with those in patients without metastasis, patients with lymph node metastasis had elevated CEA (P=0.001) and CA199 (P=0.002) levels. Patients with distant metastasis had higher white blood cells (P=0.014), neutrophils (P=0.001) and CEA (P=0.02) than that of patients without metastasis. ROC curve analysis showed that the sensitivity and specificity of fitted curves of preoperative systemic inflammation, CEA, and CA199 for ≥ T3 stage was 86.5% and 49.1%; the fitted curves of preoperative CEA and CA199 for lymph node metastasis was 67.4% and 56.7%; the fitted curves of preoperative CEA and CA199 for distant metastasis was 88.9% and 24.8%, respectively. Conclusion Preoperative routine blood tests, CEA, CA199 were significantly different among patients in terms of tumor size, lymph node positive, and distant metastasis, TNM stage which are associated with the long-term prognosis of patients with CRC. However, the predictive value and the positive relevance are limited

       

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