血清同型半胱氨酸、肿瘤标志物与转移性结直肠癌患者化疗疗效的相关性研究

目的:探讨血清同型半胱氨酸(Hcy)、肿瘤标志物与转移性结直肠癌(metastatic colorectal cancer,mCRC)患者化疗疗效的相关性。方法:选取2018年2月至2019年5月首都医科大学附属北京友谊医院肿瘤中心收治的76例mCRC患者,均确诊为结直肠癌Ⅳ期。采用mFOLFOX6方案(奥沙利铂+亚叶酸钙+5-氟尿嘧啶)联合贝伐珠单抗治疗4个周期,4个周期后进行疗效评价,并检测治疗前后血清癌胚抗原(CEA)、癌抗原199(CA199)、癌抗原125(CA125)和Hcy水平;采用有序Logistic回归分析CEA、CA199、CA125和Hcy水平变化与疗效的关系,采用Spearman相关系数法检测CEA、CA199、CA125和Hcy与疗效的相关性。结果:与治疗前比较,治疗后,部分缓解患者的CEA、CA199和Hcy水平明显降低,疾病稳定患者的CEA、Hcy水平明显升高,疾病进展患者的CA199、CA125和Hcy水平明显升高,上述差异均有统计学意义(P<0.05)。治疗前后Hcy的差值和治疗前后CEA的差值是临床疗效的风险因素,差值越大,临床治疗效果越差,差异具有统计学意义(P<0.05)。治疗前后CEA、CA199、CA125和Hcy水平的变化值与临床疗效的相关性由大至小排序为CEA>CA199>Hcy>CA125。结论:治疗前后血清CEA、CA199和Hcy水平的变化与mCRC患者化疗疗效相关,具有一定的临床价值。

Correlation Between Efficacy of Chemotherapy in Patients with Metastatic Colorectal Cancer and Serum Homocysteine and Tumor Markers

OBJECTIVE:To probe into the correlation between efficacy of chemotherapy in patients with metastatic colorectal cancer(mCRC)and serum homocysteine(Hcy)and tumor markers.METHODS:76 patients with mCRC admitted into Beijing Friendeship Hospital Affiliated to Capital Medical University from Feb.2018 to May 2019 were selected,all of whom were diagnosed as stageⅣcolorectal cancer.The therapeutic regimen of mFOLFOX6(oxaliplatin+calcium folinate+5-fluorouracil)combined bevacizumab was used for 4 courses of treatment,the efficacy was evaluated after treatment,the serum carcino-embryonic antigen(CEA),cancer antigen 199(CA199),cancer antigen 125(CA125)and Hcy levels were detected before and after treatment after treatment;the relationship between changes and efficacy in CEA,CA199,CA125 and Hcy levels was analyzed by ordered logistic regression,the correlation between efficacy and CEA,CA199,CA125 and Hcy was detected by Spearman correlation coefficient method.RESULTS:Compared with before treatment,after treatment,the CEA,CA199 and Hcy levels of patients with partial remission were significantly reduced,the CEA and Hcy levels of patients in stable disease were significantly increased,and the CA199,CA125 and Hcy levels of patients in progressive disease were significantly increased,all with statistically significant differences(P<0.05).The difference in Hcy levels before and after treatment and the difference in CEA levels before and after treatment were the risk factors of clinical efficacy,the larger the difference,the worse the clinical efficacy,with statistically significant differece(P<0.05).The correlations between clinical efficacy and changes in CEA,CA199,CA125 and Hcy levels before and after treatment were ranked as CEA>CA199>Hcy>CA125.CONCLUSIONS:Changes in serum CEA,CA199 and Hcy levels before and after treatment are related to the efficacy of chemotherapy in mCRC patients;this study has a certain clinical value.