Evaluation And Analysis Of Preoperative Determination Of Glycochain Antigen 199 And Carcinoembryonic Antigen On Prognosis Of Stage ⅱ To ⅲ Colorectal Cancer Patients

Objective:To study the prognostic effects of preoperative detection of glycochain carcinoembryonic antigen(CEA)and antigen 199(CA199)on patients with colorectal cancer stage Ⅱ～Ⅲ.Methods:150 patients with stage Ⅱ～Ⅲ colorectal cancer admitted to our hospital from January 2015 to December 2018 were selected.All subjects were followed up for three years and divided into the death group(n=60)and the survival group(n=90)according to their survival status.Preoperative CEA and CA199 levels were compared between the two groups,and the efficacy of preoperative CEA and CA199 levels in predicting prognosis of stageⅡ～Ⅲ colorectal cancer patients was determined by receiver operating characteristic(ROC)curve analysis.The baseline data of the two groups were compared,and the relationship between prognosis and related factors of patients with stage Ⅱ-Ⅲ colorectal cancer was determined by multivariate Logistic regression analysis.Results:(1)The preoperative CA199 and CEA levels in the death group were higher than those in the survival group(all P<0.05).The preoperative CEA(24.52±3.19*μg/L)and CA199(96.36±20.90*U/mL)levels in the death group were higher than the preoperative CEA(18.40 ±2.74 μg/L)and CA199(81.24±13.26U/mL)levels in the survival group(all P<0.05).(2)The age and tumor diameter of the death group were higher than those of the survival group,and the proportion of TNM stage Ⅲ,poorly differentiated and lymph node metastasis were higher than those of the survival group(all P<0.05).Gender of patients(male/female):the death group(37/23),the survival group(52/38),the difference was statistically significant(P<0.05).Age of patients(year):the death group(65.34±10.34*),the survival group(60.02±8.26),the difference was statistically significant(P<0.05).The tumor diameter(cm):the death group(5.93 ± 1.23*),the survival group(4.74±1.02),the difference was statistically significant(P<0.05).The proportion of TNM for the patients(stage Ⅱ/stage Ⅲ):the death group(24/36),the survival group(51/39),the difference was statistically significant(P<0.05).Lymph node metastasis:the death group 21(35)*,the survival group 16(17.78),the difference was statistically significant(P<0.05).The degree of differentiation(low differentiation/medium and high differentiation):the death group(27/33),the survival group(25/65),the difference was statistically significant(P<0.05).(3)Multivariate Logistic regression analysis showed that age,TNM stage Ⅱ,tumor diameter,low differentiation,lymph node metastasis,preoperative CEA and preoperative CA199 were all risk factors for poor prognosis in stage Ⅱ～Ⅲ colorectal cancer patients(all P<0.05).Impact factors:Age of patients:ninety-five percent of CI(1.193～2.495),the difference was statistically significant(P<0.05).The proportion of patients TNM(stageⅢ):ninety-five percent of CI(1.016～2.104),the difference was statistically significant(P<0.05).Low differentiation:ninety-five percent of CI(1.012～1.669),the difference was statistically significant(P<0.05).The tumor diameter:ninety-five percent of CI(1.004～1.793),the difference was statistically significant(P<0.05).Lymph node metastasis:ninety-five percent of CI(1.034～1.783),the difference was statistically significant(P<0.05).Preoperative CA199:ninety-five percent of CI(1.159～2.415),the difference was statistically significant(P<0.05).Preoperative CEA:ninety-five percent of CI(1.034～2.304),the difference was statistically significant(P<0.05).(4)ROC curve analysis showed that preoperative CA199 and CEA combined detection had higher area under the curve,sensitivity,specificity and Yuden index in predicting prognosis of patients with stage Ⅱ～Ⅲ colorectal cancer than the above two indexes alone(all P<0.05).The preoperative CEA level:ninety-five percent of CI(0.675～0.787).The preoperative CA199 level:ninety-five percent of CI(0.675～0.787).The preoperative CA199 and CEA combined level:ninety-five percent of CI(0.748～0.935).the difference was statistically significant(P<0.05).Conclusion:(1)Preoperative CEA and CA199 have a certain role in evaluating the prognosis of patients with stage Ⅱ～Ⅲ colorectal cancer,and the combined prediction effect of CEA and CA199 may be better,which is worthy of clinical application.(2)Multivariate Logistic regression analysis showed that age,TNM stage Ⅲ,tumor diameter,low differentiation,lymph node metastasis,preoperative CEA and preoperative CA199 were all risk factors for poor prognosis in stage Ⅱ～Ⅲ colorectal cancer patients.