The Value Of Perioperative CEA ? CA199 And Their Ratio In Postoperative Prognosis Of Colorectal Cancer

OJECTIVE To investigate the value of perioperative CEA,CA199 and their ratio in postoperative prognosis of colorectal cancer.METHODS A retrospective analysis of 231 patients with colorectal cancer diagnosed and treated at the First Affiliated Hospital of Guangxi Medical University from September 2012 to September 2014 was performed.The serum levels of Preoperative CEA ? CA199,and Postoperative CEA ? CA199 were detected by chemiluminescence method before operation and 1-2 weeks after operation,and CEAratio ?CA199 ratio were calculated.The c2 test was used to analyze the six observation indexes of patients with colorectal carcinoma and clinical pathological parameters;Kaplan-Meier survival curves were analyzed between the six observation indexes and colorectal cancer prognosis;multivariate analysis of prognostic factors of colorectal cancer after COX regression model.RESULTS(1)c2 test showed that preoperative serum CEA positive in tumor distant metastasis(P=0.029)and TNM staging(P=0.031)were statistically significant.Preoperative serum CA199 positivity was significantly different between the depth of tumor invasion(P=0.023),lymph node metastasis(p=0.003),tnmstaging(p=0.000),andtissuedifferentiation(p=0.035).thepostoperativeserumceapositiveindistantmetastasis(p=0.003)andtnmstaging(p=0.016)wasstatisticallysignificant.thepostoperativeserumca199positiveinpatientswithdistantmetastasis(p=0.027),lymphnodemetastasis(p=0.004)andtnmstaging(p=0.000)werestatisticallysignificant.therewasnosignificantdifferencebetweencearatioandca199 ratioinclinicalandpathologicalparameters.(2)kaplan-meiersurvivalcurveanalysisshowedthat,comparedwithceanegativepatsentsbeforesurgery,therewasnosignificantcorrelationbetweenpreoperativeceapositivecolorectalcancerandpostoperativeoverallsurvival(p=0.122);comparedtopostoperativeceanegative,preoperativeorpostoperativeca199negativeandcearatio<1,ca199<1ratio,thepatientswithpostoperativeceanegative,preoperativeorpostoperativeca199positiveandcearatio1,ca199ratio>1oftheoverallsurvivalofpatientsweresignificantlydecreased(p<0.05).(3)multivariateanalysisofcoxregressionmodelshowedthatpreoperativepositiveserumca199,cea,ratio>1,ca199ratio>1,lymphnodemetastasisanddistantmetastasisoftumorwereindependentriskfactorsofpostoperativeprognosisofcolorectalcancer.conclusion1?preoperativeserumca199weretheindependentprognosticfactorsofcolorectalcancerafteroperation,preoperativeorpostoperativeserumcealevelsandlymphnodemetastasis,tnmstagingandpathologicfactors,independentriskfactorsbutnottheoutcomeofcolorectalcancerafteroperation.2?cearatio>1,ca199ratio>1maybeoneoftheindependentriskfactorsforpostoperativeprognosisofcolorectalcancer,butitisnecessarytoincreasethesamplesizetofurtherstudy.