【摘要】 目的探讨术前外周血小板计数(PLT)与血清癌胚抗原水平(CEA)联合检测对结直肠癌患者预后评估的价值。方法回顾性分析2010年1月至2012年5月中山大学附属第三医院收治的297例结直肠癌患者临床病理资料,随访5年。卡方检验分析CEA阳性(CEA≥5μg/L)与PLT计数阳性(PLT≥350×109/L)的影响因素。Kaplan-Meier法绘制生存曲线,Log-rank检验比较生存率;COX回归分析预后的独立危险因素。结果 (1)术前血清CEA阳性与结直肠癌患者脉管癌栓、神经侵犯、浸润深度、淋巴结转移、远处转移及TNM分期较晚相关(χ~2=5.743、5.699、10.308、15.543、43.537、21.199,P=0.017、0.017、0.028、<0.01、<0.01、<0.01);PLT阳性与性别、年龄、肿瘤位置、肿瘤大小、浸润深度、远处转移显著相关(χ~2=13.409、7.749、8.496、7.324、9.295、9.196,P<0.01、0.005、0.014、0.007、0.038、0.002)。(2)生存分析提示术前血清CEA阳性、外周PLT阳性均提示不良预后(χ~2=36.926、6.892,均P<0.01)。CEA及PLT双阴性、单阳性以及双阳性患者的5年生存率分别为80.2%、51.1%、45.5%,中位生存时间分别为69、61、28个月,差异有统计学意义(χ~2=36.506,P<0.01)。(3)COX多因素回归分析提示肿瘤位置、神经侵犯、远处转移、TNM分期是影响患者预后的独立危险因素(均P<0.05)。结论术前血清CEA与外周血小板联合检测可为判断结直肠癌患者预后提供重要信息。更多还原

【Abstract】 Objective To investigate the prognostic value of preoperative serum carcinoembryonic antigen(CEA) combined with peripheral platelet count(PLT) in colorectal cancer patients. Methods From January 2010 to May 2012, clinical-pathological data of two hundred and ninety-seven colorectal cancer patients treated in the Third Affiliated Hospital of Sun Yat-sen University who finished 5 years’ followup were analyzed retrospectively. The risk factors of CEA positive(CEA≥5 μg/L) and PLT positive(PLT≥350×109/L) were judged by Chi-square test. The survival analysis with Kaplan-Meier regression and COX regression were done to investigate the prognostic value of CEA and PLT in colorectal cancer. Results(1) Positivity of preoperative serum CEA was significantly related to vascular cancer embolus, nerve invasion, the depth of invasion, lymph node metastasis, distant metastasis and TNM stages(χ~2=5.743, 5.699, 10.308, 15.543, 43.537, 21.199, P=0.017, 0.017, 0.028, <0.01, <0.01, <0.01), while gender, age, the size of tumor, tumor position, the depth of invasion and distant metastasis were significantly related to PLT positivity(χ~2=13.409, 7.749, 8.496, 7.324, 9.295, 9.196, P<0.01, 0.005, 0.014, 0.007, 0.038, 0.002).(2) Survival analysis found that positive CEA, PLT and their combination suggested poor prognosis(χ~2=36.926, 6.892, 34.821, P<0.01). The 5-year survival rate of neither, either and both positivity of CEA and PLT were 80.2%, 51.1%, 45.5%, while the median survival time was 69, 61, 28 months with statistical difference(χ~2=36.506, P<0.01).(3) COX regression revealed that the location of the tumor, nerve invasion, distant metastasis and TNM stages were the independent risk factors for the colorectal cancer(all P<0.05). Conclusion Combination of preoperative serum CEA and peripheral PLT can provide prognostic information for patients with colorectal cancer.更多还原