摘要
目的探讨局部进展期直肠癌术前新辅助放化疗中癌胚抗原（CEA）的检测意义。方法分析接受新辅助放化疗后行根治性手术的84例直肠癌患者临床资料。利用化学发光法检测新辅助放化疗前、后直肠癌患者血清CEA水平，分析放化疗后肿瘤病理完全缓解与血清CEA表达水平及下降的关系。结果全组患者新辅助放化疗后有18例达病理完全缓解（pCR），pCR率为21．4％（18／84）。单因素分析表明术前肿瘤占据肠腔≤1／2周（P=0．008）、治疗前血清CEA水平（P=0．001）、T分期（P=0．001）、N分期（P=0．049）、肛缘距离（P=0．023）与直肠癌新辅助放化疗后肿瘤pCR水平相关。经新辅助治疗后CEA下降≥50％组比CEA下降〈50％组获得pCR患者多（P=0．002）。结论直肠癌新辅助放化疗前血清CEA水平与直肠癌新辅助放化疗后肿瘤pCR水平相关。直肠癌新辅助放化疗后CEA明显下降的患者其获得pCR更显著。
Objective To investigate the significance of serum carcinoembryonic antigen （CEA） in locally advanced rectal cancer treated by neoadjuvant ehemoradiotherapy. Methods A retrospective a- nalysis was performed on the clinical data of 84 patients with rectal cancer, who underwent neoadjuvant chemoradiotherapy followed by radical surgery. The patients were all given the test of CEA level prior to and after the new adjuvant therapy. The relationship between CEA levels and pathological complate re- sponse （pCR） were assessed. Results In 84 patients, 18 （21.4%） achieved pCR after neoadjuvant chemoradiotherapy. The univariate analysis showed that circumferential extent of the tumor （ ≤1/2 cycle） （ P = 0. 008 ） , prc - chemoradiotherapy serum careinoembryonie antigen （CEA） level （ ≤5 μg/L） （ P = 0. 001 ）, pre - chemoradiotherapy T stage （ cT1 - 3 ） （ P = 0. 001 ）, pre - chemoradiotherapy N stage （ P = 0. 049） , distance between tumor and the anal verge （ ≤5 cm） （P =0. 023） were associated with pCR or non - pCR after neoadjuvant chemoradiotherapy for rectal cancer. After neo - adjuvant therapy, more pa- tients achieved pCR was observed in patients that CEA decreased ≥50%. Conclusion Patients with low CEA level are more likely to achieve pCR and patients with CEA decreased significantly are more likely to achieve greater pCR after neoadiuvant ehemoradiotherapy for rectal cancer.
作者
刘英强
陈淅涓
韩广森
刘明阁
冯稳
Liu Yingqiang;Chen Xijuan;Han Guangsen;Zhang Yonglei;Liu Mingge;Feng Wen(Department of General Surgery,the Affiliated Tumor Hospital of Zhengzhou University,Zhengzhou 450008,Chin;Department of Radiation Oncology,the Affiliated Tumor Hospital of Zhengzhou University,Zhengzhou 450008,Chin;Department of Pathology,the Affiliated Tumor Hospital of Zhengzhou University,Zhengzhou 450008,China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2018年第9期1750-1752,共3页
Chinese Journal of Experimental Surgery
基金
河南省医学科技攻关计划资助项目（201304060）
关键词
直肠肿瘤
癌胚抗原
新辅助放化疗
病理完全缓解
Rectal cancer
Carcinoembryonic antigen
Neoadjuvant chemoradiotherapy
Pathological complete response
