结直肠癌病人血清中cea ca19 9 ln与预后关系的研究-study on the relationship between serum cea ca19 ln and prognosis in patients with colorectal cancer.docx

意义(P0.05)；CA19-9 和 LN 并联检测的阳性率在肿瘤大体分型间的差异具有统计学意义(P0.05)；三种肿瘤标志物并联检测后阳性率在肿瘤大体分型及 Dukes分期间差异具有统计学意义(P0.05)。3：随访资料完整的病例 209 例，中位随访时间 25 个月，结直肠癌患者 1 年、3 年、5 年生存率分别为 92.3%，72.7%，53.8%；4：Log-rank 检验结果显示，肿瘤大小、肿瘤分化程度、淋巴结有无转移、国际 肿瘤分期标准(TNM)分期、Dukes 分期、术后是否化疗、实验室检测指标结果 (包 括术前 CEA 水平、术前 CA19-9 水平、术前 CEA+CA19-9 并联检测水平、术前 CEA+LN 并联检测、术前 CA19-9+LN 并联检测及术前 CEA+CA19-9+LN 并联检 测水平)等与结直肠癌患者生存时间相关。5：COX 比例风险回归模型筛选结果显示，术后是否化疗、Dukes 分期、三项肿 瘤标志物联检水平结果对结直肠癌患者生存时间有显著影响。结论：1：本研究观察到 CEA、CA19-9、LN 三项指标联合检测后的表达与结直肠癌临 床病理因素之间的统计学差异，但没有观察到单项指标与结直肠癌临床及病理因 素之间的关系，其结果均有待于进一步的临床及更多的人群研究来论证。2： 本研究观察到术前 CEA、CA19-9 及三种指标不同组合并联检测后表达水平 与结直肠癌的预后有关，但未观察到术前血清 LN 表达与结直肠癌预后的关系， 术前血清肿瘤标志物的升高可预测结直肠癌不良预后。3：Dukes 分期结果是影响结直肠癌患者预后的重要影响因素，应在结直肠癌患者 的治疗中充分考虑到这一因素。关键词 结直肠癌；癌胚抗原；糖类多肽抗原 19-9；层粘连蛋白；生存分析Study on the Expression of CEA、CA19-9 and LN in Blood andPrognosis of Colorectal Cancer AbstractObjective:1: To detect the expression of pre-operative serum level of CEA、CA19-9 and LN in colorectal cancer patients.2: To analyze the relationship between blood CEA、CA19-9 and LN expression andclinic pathologic factors.3: To investigate the prognosis factors of the colorectal cancer, especially to identify the expression of CEA、CA19-9 and LN with different prognosis outcomes incolorectal cancer patients, as well as to explore the expression of three tumor biomarkers’ affection related to the prognosis of the colorectal cancer.Methods:1: This study chose the cases with colorectal cancer that were confirmed by pathology at the Anorectal Hospital in Wuhan from November 2004 to August 2008. Through checking the medical record of these patients, some information were obtained and recorded in the predesigned questionnaire. The survey included demographic characteristics, clinical, pathological, laboratory indicators and some other features.2: The patients leaved the hospital were followed by telephone, in order to ascertain their survival time and prognosis outcome.3: The data was analyzed using SPSS 12.0 softwar