Serum CA125 concentration as a predictor of peritoneal dissemination of colorectal cancer in men and women.
Serum CA125 concentration as a predictor of peritoneal dissemination of colorectal cancer in men and women.
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DOI：
10.1097/md.0000000000005177
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发表时间：
2016-11
期刊：
影响因子：
1.6
通讯作者：
Yang SH
中科院分区：
文献类型：
--
作者：
Huang CJ;Jiang JK;Chang SC;Lin JK;Yang SH
癌症的腹膜播散（PD）很难诊断。以往的研究表明，糖链抗原125（CA 125）是胃癌PD的敏感标志物。然而，CA 125尚未被评估为结直肠癌（CRC）的标志物，其在男性中的准确性存在争议。本研究的目的是比较CA 125和癌胚抗原（CEA）预测男性和女性结直肠癌PD的能力。对853例患者（男性510例，女性343例）进行了10年的术前CA 125和CEA浓度测定。57例患者在术中证实PD。比较CA 125和CEA对胃癌的预测能力。与CEA相比，CA 125浓度具有较低的敏感性，较高的特异性和诊断准确性，并显着更大的曲线下面积。进一步分析CEA阴性组（n = 514）中CA 125的敏感性和特异性，其敏感性（57.1%）和特异性（92.0%）均为可接受。 在男性和女性中，CA 125浓度不随I期至IV期增加，除非存在PD（P <0.001）。 CEA在有转移的女性患者中明显升高（P <0.001），在无转移的男性患者中明显升高（P <0.01）。 CA 125浓度与男性和女性的PD分级相关，但CEA浓度仅与女性的分级相关。当根据原发肿瘤部位进行分析时，无论PD状态如何，原发部位在右侧或左侧结肠或直肠的患者之间的CA 125浓度在男性中没有差异。相比之下，PD阳性和PD阴性的右半结肠（P <0.001）或左半结肠（P <0.001）癌患者之间的CA 125浓度存在差异，但直肠中的CA 125浓度无差异。 CEA浓度在男性没有不同的主要网站或PD状态。在女性中，原发肿瘤位于右半结肠（P <0.001）或左半结肠（P <0.001）的患者中，PD阳性组和PD阴性组之间的CA 125和CEA浓度存在显著差异; PD阳性组和PD阴性组之间的肿瘤部位没有差异。 这些结果表明，CA 125是一个更好的肿瘤标志物比CEA预测PD的CRC在男性和女性。
Peritoneal dissemination (PD) of cancer is difficult to diagnose. Previous reports have shown that carbohydrate antigen 125 (CA125) is a sensitive marker of PD of gastric cancer. However, CA125 has not been evaluated as a marker of colorectal cancer (CRC), and its accuracy in men is controversial. The aim of this study was to compare the ability of CA125 and carcinoembryonic antigen (CEA) to predict PD of CRC in men and women. Preoperative CA125 and CEA concentrations were measured in 853 people (510 men, 343 women) over 10 years. PD was confirmed intraoperatively in 57 patients. The predictive ability was compared between CA125 and CEA. Compared with CEA, CA125 concentration had a lower sensitivity, higher specificity, and diagnostic accuracy, and significantly greater area under the curve. Further analysis of CA125's sensitivity and specificity among CEA-negative group (n = 514) showed acceptable sensitivity (57.1%) and good specificity (92.0%). In men and women, CA125 concentration did not increase with stage from I to IV unless PD was present (P < 0.001). CEA concentration was increased in women with metastasis with PD (P < 0.001) or without PD (P < 0.001), but was increased only in men with metastasis without PD (P < 0.01). CA125 concentration correlated with PD grade for men and women, but CEA concentration correlated with grade only in women. When analyzed according to the primary tumor site, CA125 concentration in men did not differ between patients with the primary site in the right or left colon, or the rectum, regardless of PD status. By contrast, CA125 concentration differed between PD-positive and PD-negative patients with cancer in the right (P < 0.001) or left (P < 0.001) colon but not in the rectum. CEA concentration in men did not differ according to the primary site or PD status. In women, CA125 and CEA concentrations differed significantly between the PD-positive and PD-negative groups in patients with the primary tumor in the right (P < 0.001) or left (P < 0.001) colon; tumor sites did not differ between the PD-positive and PD-negative groups. These findings suggest that CA125 is a better tumor marker than CEA for predicting PD of CRC in both men and women.