SerumCA125 As A Predictor Of Peritoneal Metastasis In Patients With Colorectal Cancer

Background:To investigate the value of serum tumor marker CA125 in predicting peritoneal metastasis of colorectal cancer.Methods:This was a retrospective review Clinical data of 1821 patients with colorectal cancer treated in Sir Run Run Shaw Hospital from 2013.1-2016.3.Clinical data were collected to analyze predictive value of serum CA125,CA19-9,CEA levels and other influence factors for peritoneal metastasis of colorectal cancer,such as liver metastasis,lung metastasis etc.Results:Among the 1821 patients with primary colorectal cancer,113 patients had peritoneal metastases,269 patients had liver metastasis and 143 patients had lung metastasis.ROC analysis showed that the accuracy of the serum CA125 level for evaluation of peritoneal metastasis of colorectal cancer was the highest.Area under ROC curve of CA125 for predicting peritoneal metastasis,liver metastasis,lung metastasis was 0.94,0.65and 0.60.Area under ROC curve of CA125,CA19-9,and CEA for predicting peritoneal metastasis was 0.94,0.71 and 0.53,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and the accuracy of serum CA125 in predicting peritoneal metastasis of colorectal cancer were 84.96%,91.33%,39.34%,98,92%and 90.93%respectively,when the positive prediction was based on CA125 level over cut off value(35u/ml).The accuracy of serum CA125 to diagnose liver metastasis and lung metastasis were 79.96%,82.70%,while the accuracy of serum CA19-9 and CEA to diagnose peritoneal metastasis were 56.10%and 41.61%.The result of univariate analysis showed that,age,gender,tumor locations,liver metastasis,lung metastasis,serum level of CEA,CA19-9 and CA125,were risk factors of peritoneal metastasis of colorectal cancer,that incidence rates of peritoneal metastasis in patients with female sex,age<60years old,right-side tumor,liver metastasis,lung metastasis,increase of CEA,CA19-9,and CA125 level were higher(P<0.05).The result of logistic regression showed that,gender,tumor locations,liver metastasis,level of CEA,CA19-9,CA125 were the risk factors of peritoneal metastasis of colorectal cancer,that incidence rates of peritoneal metastasis in patients with female sex,right-side tumor,liver metastasis,increase of CEA,CA19-9 and CA125 level,Conclusion:female,right-side tumor,liver metastasis,increase of serum CEA,CA19-9 and CA125 level are independent risk factors for peritoneal metastasis of colorectal cancer.The influence of CA125 level in was most significant,which may provide a predictable value in determining peritoneal metastasis in patients with colorectal cancer.