CEA水平与进展期直肠癌新辅助放化疗疗效的关系

目的探讨癌胚抗原在预测进展期直肠癌对术前新辅助放化疗反应中的作用。方法对我院接受术前新辅助放化疗的48例进展期直肠癌分组，按照治疗前CEA的水平分为CEA升高组和CEA正常组，对切除术后标本进行分析，比较两组病例在肿瘤局部降期及肿瘤消退方面的差异。结果CEA升高组共21例，其中术后肿瘤降期（包括术后病理ypT02有12例，57％），出现肿瘤消退（包括TGR2~4者11例，52％）CEA正常组共27例，其中术后肿瘤降期（包括术后病理ypT02有20例，74％），出现肿瘤消退（包括TGR2~4者21例，78％）。CEA升高组肿瘤降期及消退比率均低于CEA正常组。结论治疗前CEA水平的升高可能预示直肠癌对术前新辅助放化疗的反应性差，有助于直肠癌患者个体化治疗方案的选择。

The value of CEA level in predicting tumor response after preoperative chemoradiotherapy for advanced rectal cancer

Objective To analyze pretreatment level of the serum carcinoembryonic antigen(CEA)that could predict tumor response to preoperative chemoradiotherapy(CRT) for advanced rectal cancer.Methods The study involving 48 patients who underwent preoperative CRT followed by surgery were divided into two groups:CEA normal group and CEA elevated group.Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and tumor regression.Statistical analyses were performed to identify CEA level associated with tumor response.Results In CEA elevated group(21cases),tumor downstaging(defined as ypT2 or less) was observed in 12 patients(57%),whereas tumor regression(defined as Dworak’s Regression Grades 3 or 4) was observed in 11 patients(52%).In CEA normal group(27 cases),tumor downstaging was observed in 20 patients(74%),whereas tumor regression was observed in 21 patients(78%).Conclusion The data suggest that pretreatment CEA level is the important clinical predictor of tumor response after CRT.It may be of benefit in the selection of treatment options as well as the assessment of individual prognosis.