Cyclooxygenase (COX-2) And Serum Carcinoembryonic Antigen (CEA) As Prognostic Factors For Neoadjuvant Chemoradiation Curative Effect And Prognosis Of Patients With Rectal Cancer

Objectives:1.To clarify the effect of COX-2 and CEA on the efficacy of neoadjuvant chemoradiotherapy in patients with rectal cancer.2.To clarify the effect of COX-2 and CEA expression on prognosis of patients with rectal cancer.3.Explore the relationship between COX-2 expression and CEA.Methods:Collected in January 1,2010-2014 on December 31,our line of neoadjuvant chemoradiation after surgical treatment of colorectal cancer patients,were included in the 116 cases into the group standard,collect these patients tumor tissue specimens,immunohistochemical method to detect the expression of COX-2.At the same time record in patients with preoperative and postoperative serum CEA levels.The following indexes were recorded retrospectively:1.General conditions(gender,age,etc.);2.Stage of rectal cancer;3.Evaluation of the efficacy of neoadjuvant chemotherapy;4.Recurrence time,survival and metastasis.In the manner of data access,a retrospective record of 3 months after the operation was performed,and the patient was followed up for 3 years or died.The efficacy of neoadjuvant chemotherapeutic chemotherapy was evaluated by TNM reduction stage,tumor reduction degree and evaluation criteria for efficacy of solid tumors(RECIST).To analyze the data with SPSS 22.0 software,using the chi-square analysis COX-2 expression and CEA in patients with neoadjuvant chemoradiation curative effect and prognosis,the influence of using the Spearman correlation analysis of COX-2 expression and the correlation of CEA expression level.Results:1.Among the 116 patients undergoing neoadjuvant chemotherapy,the expression of COX-2 was negatively correlated with the DFS rate after 3 years after surgery(P<0.05),and the positive expression rate of COX-2 was lower in patients with DFS for 3 years.COX-2 expression was not associated with tumor reduction,TNM reduction and efficacy,no statistical significance(P>0.05).2.The decrease of CEA was positively related to the reduction of tumor after neoadjuvant chemoradiotherapy.The greater the decline of CEA,the greater the reduction of tumor radiotherapy(P<0.05),the lower the CEA before neoadjuvant chemoradiation,the higher DFS rates were in patients after surgery(P<0.05).The average level of CEA in CR group(10.82ug/L)was lower than that of non-CR group (23.72ug/L),but the difference was not statistically significant.The CEA level of TNM stage reduction group was lower than that of non-subtraction group,but the difference was not statistically significant(P>0.05).There was no significant relationship between CEA level and lymph node staging and neoadjuvant therapy(P>0.05).3.COX-2 expression and CEA level are positively correlated relationship.The patients whose COX-2 positive expression have higher CEA level,difference was statistically significant(P<0.05).Conclusions:1.The expression of COX-2 was negatively correlated with 3-year DFS.COX-2 has predictive effect on curative effect to some extent.After neoadjuvant therapy,COX-2 was elevated,which was associated with resistance to neoadjuvant chemoradiotherapy.2.The level of CEA were negatively associated with the reduction of tumor and 3 years of DFS.CEA had a certain predictive effect on the efficacy and prognosis of neoadjuvant chemotherapy.3.COX-2 expression and CEA level has close relationship,the combination of the two can improve the efficacy and prognosis of neoadjuvant chemotherapy for rectal cancer.