Combined Application Of Preoperative Multiple Serum Tumor Markers For Predicting Liver Metastasis Of Colorectal Cancer

Objective To study the value of combined detection of multiple serum tumor markers before surgery for predicting liver metastasis of colorectal cancer.Methods A total of 316 patients with colorectal cancer who underwent surgery at the Cancer Hospital of Chinese Academy of Medical Sciences from January 2015 to January 2017 were enrolled in this study.Among them,158 patients with colorectal cancer and liver metastases were included in the observation group.Other 158 case-matched patients with colorectal cancer without liver metastases were included in the control group.Preoperative serum carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 50(CA50),alpha-fetoprotein(AFP)and tissue polypeptide specific antigen(TPS)were measured in all patients.The univariate and multivariate analysis of the above tumor markers were used alone or in combination in this study.Results Preoperative serum CEA,CA19-9,CA50,AFP,and TPS were significantly increased in patients with liver metastases from colorectal cancer(P<0.05),and were associated with pathological stage(P<0.05).The positive rate of combined detection of five tumor markers(83.5%)was higher than that of single detection(48.7%)or two(53.8%),three(60.1%),and four(69.6%)combined detection.The results of univariate and multivariate analysis showed that increased preoperative serum CEA,CA19-9 and CA50 significantly correlated with liver metastases in patients with colorectal cancer(P<0.05).The sensitivity of CEA,CA19-9 and CA50 in predicting colorectal cancer liver metastasis was 62.7%,57.4%and 67.1%,respectively;the specificities were 58.2%,53.5%,56.6%,respectively.The sensitivity and specificity of combined diagnosis of CEA,CA19-9,and CA50 for liver metastasis in colorectal cancer were 74.3%and 76.3%,respectively.Conclusions Preoperative serum CEA,CA19-9,CA50,AFP and TPS have certain value in the diagnosis and clinical staging of colorectal cancer liver metastasis.The combined value of five indicators in predicting liver metastasis of colorectal cancer is better than single or arbitrary index.Combined detection can effectively improve the diagnosis rate of liver metastases from colorectal cancer.CEA,CA19-9,and CA50 are independent predictors of liver metastasis of colorectal cancer.The combined detection of the three methods has high sensitivity and specificity for the diagnosis of colorectal cancer liver metastasis.Therefore,it is of great significance to detect serum CEA,CA19-9,and CA50 levels when predicting liver metastases from colorectal cancer.