The Value Of Combined MSEPT9 And CEA Detection In The Follow-up Of Stage Ⅰ-Ⅲ Colorectal Cancer

Objective:To investigate the value of combined detection of plasma Septin-9methylation(mSEPT9)and serum CEA in postoperative follow-up of colorectal cancer.Methods:To collect the clinicopathological and follow-up data of patients diagnosed with stage I-III concurrent radical resection of colorectal adenocarcinoma in our hospital from march 2018 to december 2018.to analyze the correlation between plasma mSEPT9 and serum CEA expression levels and clinicopathological parameters,tumor-bearing status,and postoperative tumor progression-free survival time,and to explore the value of combined plasma mSEPT9 and serum CEA detection in the diagnosis of postoperative recurrence and metastasis of colorectal cancer.Results:1.The positive rate of plasma mSEPT9 in preoperative patients with colorectal cancer was 68.3%,and the positive rate of serum CEA inpreoperative patients with colorectal cancer was 48.3%.the difference was statistically significant(P<0.05).there was a positive correlation between plasma mSEPT9 and serum CEA expression in preoperative patients with colorectal cancer(r=0.477,P<0.05).2.The univariate correlation analysis showed that the positive rate of preoperative plasma mSEPT9 was associated with tumor size,lymph node metastasis,and TNM clinical stage(P<0.05);Logistic multivariate regression analysis showed that only TNM clinical stage was associated with the positive rate of preoperative plasma mSEPT9(P<0.05).Univariate correlation analysis showed that the positive rate of preoperative serum CEA was related to tumor size,differentiation,lymph node metastasis,vascular invasion and TNM clinical stage(P<0.05);Logistic multivariate regression analysis showed tumor differentiation,lymph node metastasis and TNM clinical stage was associated with the positive rate of preoperative serum CEA(P<0.05).3.The positive rate of plasma mSEPT9 and serum CEA expression in patients with colorectal cancer one week after operation was significantly lower than that before operation(P<0.05).4.The sensitivity of plasma mSEPT9 in the diagnosis of postoperative recurrence and metastasis of colorectal cancer was 68.4%,the specificity was 75.9%,the area under ROC curve was 0.753;The sensitivity of serum CEA in the diagnosis of postoperative recurrence and metastasis ofcolorectal cancer was 47.4%,the specificity was 79.3%,and the area under the ROC curve was 0.636;The sensitivity of plasma mSEPT9 combined with serum CEA for the detection of postoperative recurrence and metastasis in colorectal cancer patients was 89.5%,the specificity was68.0%,the sensitivity was significantly higher than serum CEA alone(P<0.05),and the area under the ROC curve 0.803.5.The results of univariate survival analysis of colorectal cancer prognosis showed that patients with low/undifferentiated tumor,clinical stage II/III,lymph node metastasis positive,postoperative plasma mSEPT9 positive,postoperative serum CEA positive,combined plasma mSEPT9 and serum CEA positive had shorter postoperative tumor progression-free survival time(all P<0.05).the results of multivariate Cox regression analysis showed that postoperative combined plasma mSEPT9 and serum CEA positive were independent risk factors for tumor progression-free survival in colorectal cancer patients(P<0.05,HR=4.237).Conclusion:1.The positive rate of preoperative plasma mSEPT9 and serum CEA in patients with stage I-III colorectal cancer was closely related to its clinicopathological parameters and tumor-bearing status,which can provide reference for the evaluation of surgical efficacy and prognosis.2.The combined detection of plasma mSEPT9 and serum CEA is helpful to improve the diagnostic efficacy of postoperative recurrence andmetastasis in patients with stage I-III colorectal cancer.The combination of positive detection of both is an independent risk factor affecting the survival of postoperative tumor progression-free in patients with colorectal cancer.