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目的 Cyfra21-1是常见的血清肿瘤标志物之一,但其在肠癌中的研究较少。本研究旨在分析肠癌患者术前Cyfra21-1水平和临床病理参数的关系。方法收集解放军总医院海南分院2012-06-01-2016-06-01经病理确诊的肠癌患者115例,将患者性别、年龄、肿瘤位置、肿瘤细胞分化程度、TNM分期、微卫星状态、Ki-67指数和危险因素等与Cyfra21-1、CEA水平进行统计分析。结果术前Cyfra21-1和CEA的阳性率分别为38.26%(44/115)和37.39%(43/115),双阳性和仅Cyfra21-1的阳性率均为19.13%(22/115),仅CEA阳性率为18.26%(21/115),双阴性率43.47%(50/115)。术前Cyfra21-1水平在不同的肿瘤细胞分化程度(χ~2=14.47,P<0.001)和M分期(χ~2=4.62,P=0.03)中差异有统计学意义,而术前CEA水平在不同的T(χ~2=17.72,P=0.00)、M(χ~2=7.81,P<0.001)及TNM分期(χ~2=19.26,P<0.001)差异有统计学意义。肿瘤最大径及阳性淋巴结数在两者升高组中均对应升高,均P<0.05。Logistic多因素回归分析提示,对术前Cyfra21-1水平存在重要影响因素的是肿瘤细胞分化程度和肿瘤最大径;相对于低分化,中分化OR=0.17,95%CI为0.04~0.69,P=0.01;高分化OR=0.06,95%CI为0.00~0.78,P=0.03。结论术前Cyfra21-1水平在肠癌患者中具有较高的阳性率,可能对判断肿瘤细胞分化程度、肿瘤侵犯范围等提供一定帮助。
Purpose Cyfra21-1 is one of the common serum tumor markers, but its research in colorectal cancer is less. The purpose of this study was to analyze the relationship between preoperative Cyfra21-1 levels and clinicopathological parameters in patients with colorectal cancer. METHODS: A total of 115 patients with colorectal cancer diagnosed by pathology were collected from Hainan Branch of People’s Liberation Army General Hospital. The patients’ gender, age, tumor location, tumor cell differentiation, TNM stage, microsatellite status, Ki -67 index and risk factors such as Cyfra21-1, CEA levels for statistical analysis. Results The positive rates of Cyfra21-1 and CEA before surgery were 38.26% (44/115) and 37.39% (43/115), respectively. The positive rates of double positive and only Cyfra21-1 were 19.13% (22/115), only The positive rate of CEA was 18.26% (21/115) and the double negative rate was 43.47% (50/115). The preoperative level of Cyfra21-1 was significantly different in different degree of tumor cell differentiation (χ ~ 2 = 14.47, P <0.001) and M stage (χ ~ 2 = 4.62, P = 0.03) The difference was statistically significant at different T (χ ~ 2 = 17.72, P = 0.00), M (χ ~ 2 = 7.81, P <0.001) and TNM stage (χ ~ 2 = 19.26, P <0.001). The maximum diameter of tumor and the number of positive lymph nodes increased in both groups, both P <0.05. Logistic multivariate regression analysis showed that the preoperative Cyfra21-1 levels are important factors affecting the degree of tumor cell differentiation and tumor diameter; relative to poorly differentiated, moderately differentiated OR = 0.17, 95% CI 0.04 ~ 0.69, P = 0.01; well-differentiated OR = 0.06, 95% CI 0.00-0.78, P = 0.03. Conclusion Preoperative Cyfra21-1 levels in patients with colorectal cancer have a high positive rate, may determine the degree of tumor cell differentiation, tumor invasion range to provide some help.