论文部分内容阅读
[目的]探讨直肠癌术前血清肿瘤标志物水平与肿瘤浸润深度及淋巴结转移之间的关系,评价其在直肠癌术前分期中的应用价值。[方法]回顾性分析北京大学肿瘤医院178例行手术治疗直肠癌患者的术前血清肿瘤标志物(CEA、CA199、CA724、CA242)水平和临床病理资料。[结果]单因素分析结果表明直肠癌肿瘤浸润深度与术前CEA、CA242水平、肿瘤部位、最大径、大体类型、分化程度、淋巴结转移相关(P<0.05)。淋巴结转移与肿瘤大体类型、分化程度、最大径、脉管癌栓、浸润深度相关(P<0.05)。多因素分析表明直肠癌患者术前的CEA水平和肿瘤最大径是肿瘤浸润深度的独立危险因素;肿瘤浸润深度和脉管癌栓是淋巴结转移的独立危险因素。[结论]术前血清CEA水平是影响直肠癌术前T分期的重要因素,术前血清肿瘤标志物水平对直肠癌术前分期的应用价值有限。
[Objective] To investigate the relationship between preoperative serum tumor markers and the depth of tumor invasion and lymph node metastasis, and to evaluate its value in the preoperative staging of rectal cancer. [Methods] The preoperative serum tumor markers (CEA, CA199, CA724, CA242) and clinicopathological data were retrospectively analyzed in 178 patients with rectal cancer in Peking University Cancer Hospital. [Results] The results of univariate analysis showed that the depth of tumor invasion in rectal cancer was correlated with preoperative CEA, CA242 level, tumor location, maximum diameter, gross type, degree of differentiation and lymph node metastasis (P <0.05). Lymph node metastasis was related to the general type of tumor, degree of differentiation, maximum diameter, vascular tumor thrombus and depth of invasion (P <0.05). Multivariate analysis showed that preoperative CEA level and maximum tumor diameter were the independent risk factors of tumor invasion depth. The depth of tumor invasion and vascular thrombosis were independent risk factors of lymph node metastasis. [Conclusion] The preoperative serum CEA level is an important factor affecting the preoperative T stage of rectal cancer. Preoperative serum tumor marker level has limited value in the preoperative staging of rectal cancer.