构建癌胚抗原、糖类抗原19-9生存模型公式预测结直肠癌患者生存时间*

目的 构建术前癌胚抗原(CEA)、糖类抗原19-9(CA19-9)模型,预测结直肠癌(CRC)患者的生存时间。方法 收集江门市中心医院就诊的313例CRC患者,利用Beckman Access化学发光免疫分析仪检测CRC患者术前血清CEA、CA19-9水平,运用χ²检验评估其与CRC患者临床病理参数的关系,Kaplan-Meier生存分析和Cox多因素分析分别评估CRC患者生存及预后。结果 CEA、CA19-9均与CRC患者pT、pN、pM分期,临床Ⅰ、Ⅱ、Ⅲ、Ⅳ分期,进展,复发,脉管浸润,转移部位等因素相关(P<0.05)。CEA升高患者的总生存时间(OS)较CEA正常患者缩短(76.85个月vs 110.83个月,P=0.000)。CA19-9升高患者的OS也有相同趋势(P=0.000)。Cox多因素分析发现CEA、CA19-9是预测CRC患者生存的独立因素(HR分别为2.190和2.874;95%CI分别为1.486～3.225和1.947～4.242;P均<0.05)。联合CEA、CA19-9构建模型公式,赋予CEA正常为0分,CEA升高为1分...

Constructing a CEA and CA19-9 survival model to predict the survival time of colorectal cancer patients

Abstract : Objective To construct a model for predicting the survival time of colorectal cancer(CRC) patients based on the preopera-tive carcinoembryonic antigen(CEA ) and carbohydrate antigen 19-9(CA19-9)levels.Methods 313 patients with CRC from JiangmenCentral Hospital were collcted and their preoperative serum CEA and CA19-9 levels were dected using a Beckman Access chemilu-minescence immunoassay analyzer.TheX''test was used to evaluate the relationships between CEA and cinical pathological factors andhbetween CA19-9 and clinical pathological factors, and the Kaplan-Meier survival analysis and Cox multivariate analysis were used to as-sess the survival and prognosis of patients , respectively.Results CEA and CA19-9 levels were correlaterd with ''TNM staging, clinicalstages l,Ⅱ Ⅲ , and N , progression , recurrence,vascular invasion , and metastatic sites of CRC( P<0.05 ). The overall survival time(0S ) of patients with elevated CEA was shorter than that of patients with normal CEA,with a total of 76.85 months,while the 0S ofpatients with normal CEA was 110.83 months(P=0.000). The same trend was olserved i patients with elevated CA19-9( P=0.000).Cox mulivariale analysis found that CEA and CA19-9 were independent predictors of survival in CRC patients( HR=2.190 and 2.874,95%CI=1.486-3.225 and 1.947-4.242,respectively;P<0.05). A model formula combining CEA and CA19-9 was constructed, assig-ning a score of 0 for normal CEA, 1 for elevated CEA, and 0 for normal CA19-9, 1 for elevated CA19-9.The CC value was set to equalCEA score+CA19-9 score. It was found that the patients with the highest CC value had the shortest OS, while the patients with the low-est CC value had the longest OS( P<0.05). Concusion The established CEA and CA19-9 model formula can effectively distinguishthe prognosis of CRC patients.