血清CA125对结直肠癌腹膜转移的预测价值分析

发布时间：2018-04-01 09:31

本文选题：结直肠癌　切入点：腹膜转移　出处：《浙江大学》2017年硕士论文

【摘要】：目的:探讨血清CA125对结直肠癌腹膜转移的预测价值以及其他临床血清学、病理学特征对腹膜转移的影响。方法:回顾性收集2013年1月-2016年3月期间在浙江大学医学院附属邵逸夫医院收治的1821例确诊为结直肠癌患者的临床资料,统计血清CA125、CA19-9、CEA等肿瘤标志物水平及肝、肺、腹膜转移等临床特征进行统计学分析。结果:1821例患者中,113例患者发生腹膜转移,269例患者发生肝转移,143例患者发生肺转移。受试者工作特征(ROC)分析显示血清CA125对结直肠癌腹膜转移术前判断的准确率最高,CA125预测结直肠癌腹膜转移、肝转移、肺转移的ROC曲线下面积分别为0.94,0.65,0.60,CA125,CA19-9和CEA预测腹膜转移的ROC曲线下面积分别为0.94,0.69和0.53。以35u/mL作为血清CA125的临界值血清CA125预测结直肠癌腹膜转移的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为84.96%,91.33%,39.34%,98.92%和90.93%,而用于诊断肝、肺转移的准确率分别为79.96%,82.70%。而CA19-9和CEA的诊断结直肠癌腹膜转移的准确率为56.10%和41.61%。单因素分析结果显示:性别、年龄、肿瘤位置、肝转移、肺转移、CA125水平、CA19-9水平、CEA水平,均是结直肠癌腹膜转移的影响因素(P0.05),女性、年龄60岁、右半结肠肿瘤、发生了肝、肺转移、CEA水平、CA19-9水平、CA-125水平增高的结直肠癌患者发生腹膜转移的概率较高。logistic回归分析结果显示:性别、肿瘤位置、肝转移、CA-125水平、CA19-9水平、CEA水平,均是结直肠癌腹膜转移的影响因素(P0.05),女性、右半结肠肿瘤、发生肝转移、CEA水平、CA19-9水平、CA-125水平增高的患者发生腹膜转移的概率较高。结论:女性、右半结肠肿瘤、发生了肝转移、CEA水平增高、CA19-9水平增高、CA-125水平增高均是结直肠癌腹膜转移的危险因素,其中CA125水平对其影响最为显著,对结直肠癌腹膜转移有较高的预测价值。
[Abstract]:Objective: to investigate the predictive value of serum CA125 in peritoneal metastasis of colorectal cancer and other clinical serology. Methods: the clinical data of 1821 patients with colorectal cancer were collected retrospectively from January 2013 to March 2016 at run run Shaw Hospital affiliated to Zhejiang University Medical College. Serum CA125, CA19-9, CEA and other tumor markers, liver and lung were counted. The clinical features such as peritoneal metastasis were analyzed statistically. Results in 113 of 1821 patients with peritoneal metastasis, 269 patients had hepatic metastasis and 143 patients had pulmonary metastasis. The accuracy of preoperative diagnosis of peritoneal metastasis in rectal cancer was the highest. CA125 was used to predict peritoneal metastasis of colorectal cancer. The areas under the ROC curve of liver metastasis and lung metastasis were 0.94 ~ 0.65 and 0.60% CA125A CA19-9 and 0.94 ~ 0.69 and 0.53 respectively. The sensitivity and specificity of 35u/mL as the critical value of serum CA125 for predicting peritoneal metastasis of colorectal cancer were analyzed. The positive predictive value, the negative predictive value and the accuracy rate were 84.96%, 91.33% and 39.34%, respectively. The accuracy of diagnosis of liver and lung metastasis were 79.96% and 82.70, respectively. The accuracy of CA19-9 and CEA in diagnosing peritoneal metastasis of colorectal cancer was 56.10% and 41.61.The results of univariate analysis showed that: sex, Age, tumor location, liver metastasis, CA125 level, CA19-9 level and CEA level were all factors influencing peritoneal metastasis of colorectal cancer. Female, 60 years old, right hemicolon tumor, developed liver. The incidence of peritoneal metastasis in colorectal cancer patients with higher levels of CA-125 was higher than that of patients with lung metastasis. Logistic regression analysis showed that: sex, tumor location, CA-125 level of liver metastasis and CA19-9 level were correlated with CEA level. All of them were the influencing factors of peritoneal metastasis of colorectal cancer (P 0.05), female, right hemicolon tumor, patients with liver metastasis with high level of CEA and CA-125 were more likely to develop peritoneal metastasis. Conclusion: female, right hemicolon tumor, right hemicolon tumor. Increased levels of CA19-9 and CA-125 were the risk factors of peritoneal metastasis of colorectal cancer. The level of CA125 had the most significant effect on the peritoneal metastasis of colorectal cancer, and had a high predictive value for peritoneal metastasis of colorectal cancer.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

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