| Objective: The purpose of this study was : 1, To understand the relationship between preoperative carcinoembryonic antigen( CEA) and fibrinogen(FIB) in patients with colorectal cancer. 2, The relationship between the evaluation of preoperative CEA and FIB levels and clinicopathological features of colorectal cancer patients. 3, To investigate the relationship between the level of CEA and FIB and the staging of colorectal carcinoma. 4, The analysis of the relationship between the preoperative CEA and FIB levels and colorectal cancer metastasis.5, Further explore the relationship between preoperative carcinoembryonic antigen and fibrinogen levels and prognosis in patients with colorectal cancer. Methods:1, Collecting from March 2010 to August 2013 in Sichuan Province Tumor hospital surgical treatment of colorectal cancer patients for a total of 419 cases, preoperative CEA and FIB was detected between the clinical and pathological features of colorectal cancer patients, stage, metastasis and prognosis in the clinical application value of. 2, The design of the study follow-up. The follow-up time from surgery date to September 2015, the follow-up to postoperative follow-up(to review the hospital) and telephone follow-up. Collecting medical records as a clinical pathological data. The contents include:(1)General characteristics: age, gender, etc.;(2) laboratory detection of FIB and CEA;(3) Treatment: surgery, postoperative auxiliary treatment, surgery after the presence of complications, such as.(4) The pathological characteristics: tumor location, size, histological type, postoperative removal from lymph node number. 3, the use of spss20.0 software for statistical analysis of data, lost to follow-up were analyzed using 2 test; for preoperative fibrin and carcinoembryonic antigen data do not obey normal distribution, correlation analysis using Spearman correlation, two and colorectal cancer patients with clinical pathological features between using the Wilcoxon rank sum test; 1, 3, 5 years survival rate calculated by life table method and compared using the log rank test; and prognosis of colorectal cancer between survival curves were plotted using the Kaplan- Meier, survival curves were compared with the log rank test; Cox proportional hazards regression model on prognosis of single and multiple factors analysis. Test level of alpha, ?=0.05 P<0.05 has statistical significance. Results: 1, Correlation: Spearman test results showed that FIB and CEA have positive correlation, rank correlation coefficient is 0.1066.(P=0.0289<0.05). 2, Relationship with clinical pathological features: rank sum test results showed that, preoperative FIB and CEA levels were with colorectal cancer maximum transverse diameter, mode of operation(P < 0.05), and gender, excision of lymph nodes, tumor tissue learn type, degree of differentiation, vascular God invasion by independent(P>0.05). In addition, preoperative FIB level with age, location of the tumor(P<0.05); preoperative CEA level also and neural invasion(P<0.05). 3, Relationships between the stage: preoperative FIB level and colorectal cancer T stage(invasive depth), M stage(distant metastasis), TNM stage(P<0.05); and CEA levels also and T staging(depth of invasion) and N stage(lymph node transfer) and M staging(distant metastasis and TNM stage(P<0.05). In addition, there are still high stage FIB, CEA was significantly higher than the low stage, the difference was statistically significant(P<0.05). 4, Relationship with metastasis: median preoperative FIB and CEA were only distant metastasis who was the highest(3.71, 3.209), higher than the other three groups(P<0.05); appear distant metastasis and lymph node metastasis, FIB and CEA values were higher than without metastasis(P<0.05). In addition, we also found that in different lymph node metastasis(N staging) in preoperative CEA level are also different and lymph node transfer number many, the CEA level high(P<0.05). 5, Relationship between the prognosis:(1) were detected FIB and CEA, found that: compared to the FIB and CEA normal(FIB?4g/L or CEA?5 ng/ml), FIB and CEA levels were elevated(FIB > 4g / L or CEA > 5 ng / ml), colorectal cancer patients after average survival was significantly shorter and operation after 1, 3, 5 year survival rate were significantly decreased and postoperative survival curve, there was a significant difference(P<0.05).(2)combined detection of FIB and CEA, found that: compared with the FIB and CEA were normal, FIB and CEA levels were elevated, colorectal cancer patients after 5 years survival rate(%) was the lowest, visible when the FIB and CEA were positive and the prognosis of patients with the worst(P < 0.001). Any party with elevated FIB and CEA, to varying degrees of impact nodes the prognosis of patients with rectal cancer, and regardless of the FIB increased or not,CEA increase high enable patients 5 years survival rate decreased(P< 0.05). But when CEA is normal, FIB of patients with postoperative 5 year survival rate was not statistically significant(P=0.371 > 0.05).(3)The single factor analysis results: FIB and CEA, preoperative complications, operation of intestinal obstruction, N staging(lymph node metastasis), M stage, distant metastasis, TNM stage, perineural invasion, metastasis, surgery(radical or palliative), tumor maximum transverse diameter, operation excision lymph node number, cut and whether margin positive is affected junction factors of prognosis of patients with rectal cancer(P < 0.05).(4)Multiple factor analysis results: CEA, N staging(lymph node metastasis), M stage(distant metastasis), tumor maximum transverse diameter is independent risk factors for the prognosis of patients with rectal cancer(P < 0.05), but did not find FIB is the node independent factors for the prognosis of patients with rectal cancer(P = 0.395>0.05, 95% CI:0.624-1.205). Conclusions:1, Colorectal cancer patients with preoperative CEA and FIB levels have a positive correlation; with CEA similar, FIB in colorectal cancer preoperative staging, metastasis, prognosis, and so there is a certain clinical value. 2, Colorectal cancer patients with preoperative CEA, FIB levels and patients with general clinical pathological characteristics closely, in the clinical work has a certain guiding significance. 3, CEA, FIB detection in colorectal cancer with a certain preoperative diagnosis of the value, may be a more convenient and more efficient means of supplement. 4, The detection of FIB and CEA in colorectal cancer has a certain predictive value, and the two may be an effective predictor of metastasis(lymph node metastasis and / or distant metastasis). 5, The detection of FIB and CEA has a certain value in the prognosis of colorectal cancer, and the combined detection of the two is more meaningful. |
PDF Full Text Request