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目的观察大肠癌肝转移后患者外周血癌胚抗原(carcinoembryonic antigen,CEA)、糖链抗原19-9(chain antigen19-9,CA19-9)水平变化及与预后的相关性。方法选择2010年1月—2012年12月大肠癌肝转移患者66例,随机分为实验组、对照组各33例。实验组采用介入栓塞化疗联合口服希罗达治疗,对照组采用静脉化疗联合口服希罗达治疗。比较两组治疗前后CEA、CA19-9水平变化。计量资料比较采用t检验,计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果治疗前实验组CEA、CA19-9水平分别为(61.14±17.28)mg/l、(113.78±24.82)μg/l,对照组分别为(60.92±16.58)mg/l、(113.17±24.52)μg/l;治疗后实验组血清CEA、CA19-9水平分别为(14.29±3.65)mg/l、(25.84±7.17)μg/l,对照组分别为(17.61±4.17)mg/l、(29.62±8.22)μg/l。两组治疗后CEA、CA19-9水平均较治疗前明显降低(均P<0.05),治疗后两组血清CEA、CA19-9水平比较差异无统计学意义(均P>0.05)。治疗前血清CEA、CA19-9升高患者1、2、3年生存率分别为42.42%(14/33)、12.12%(4/33)、0;未升高患者分别为75.76%(25/33)、51.52%(17/33)、21.21%(7/33);比较差异有统计学意义(均P<0.05)。结论大肠癌肝转移后患者外周血CEA、CA19-9水平升高,二者水平变化可反映患者预后,可作为治疗后监测复发和转移的指标。
Objective To observe the changes of carcinoembryonic antigen (CEA), chain antigen19-9 (CA19-9) in patients with liver metastasis of colorectal cancer and its correlation with prognosis. Methods Sixty-six patients with liver metastasis of colorectal cancer from January 2010 to December 2012 were randomly divided into experimental group and control group with 33 cases each. The experimental group was treated with interventional chemoembolization combined with oral Xeloda, while the control group was treated with intravenous chemotherapy combined with oral Xeloda. The changes of CEA and CA19-9 before and after treatment were compared between the two groups. Measurement data were compared using t test, count data were compared using χ2 test, P <0.05 for the difference was statistically significant. Results Before treatment, the levels of CEA and CA19-9 in the experimental group were (61.14 ± 17.28) mg / l and (113.78 ± 24.82) μg / l, respectively, and those in the control group were 60.92 ± 16.58 and 113.17 ± 24.52 μg / / l; After treatment, the levels of serum CEA and CA19-9 in the experimental group were (14.29 ± 3.65) mg / l and (25.84 ± 7.17) μg / l respectively, while those in the control group were (17.61 ± 4.17) mg / 8.22) μg / l. The levels of CEA and CA19-9 in both groups were significantly lower than those before treatment (all P <0.05). There was no significant difference in serum CEA and CA19-9 between the two groups after treatment (all P> 0.05). The 1-year, 2-year and 3-year survival rates of patients with elevated CEA and CA19-9 before treatment were 42.42% (14/33) and 12.12% (4/33), respectively, while those without elevation were 75.76% 33), 51.52% (17/33) and 21.21% (7/33), respectively. The difference was statistically significant (all P <0.05). Conclusion The levels of CEA and CA19-9 in peripheral blood of patients with colorectal cancer after hepatic metastasis increase, and the changes of the two levels can reflect the prognosis of patients, which can be used as an indicator to monitor recurrence and metastasis after treatment.