Multislice Spiral CT Images Combined With CEA,Lymphocyte And Neutrophil Ratio Predict Recurrence And Metastasis Postoperative Of Rectal Cancer

Objective:To exploring the earlier predictors of postoperative recurrence and metastasis of rectal cancer and analysis it's risk to make a model.Patients and methods:Retrospective collection The patients with rectal cancer underwent surgical resection and pathological diagnosis of 400's from September 2013to September 2014 The patients have had test that postoperative period(chest,abdomen and pelvic)imaging examination,serum tumor markers,blood routine follow-up for 3 years at least.Statistics in patients with preoperative CT examination in the lesion size,postoperative 3,6,12 month serum carcinoembryonic antigen(CEA),cancer antigen carcinoembryonic 242(CA242),carcinoembryonic299(CA199)level,peripheral blood lymphocyte and granulocyte ratio of conventional.Using Cox proportional hazards model(hazard ratio[HR])for the above multivariable regression analysis,the relevant variables significantly using X-tile software according to the risk(HR)hierarchical analysis,combining Kaplan-Meier curves are stratified analysis to high and low risk of recurrence and metastasis.Based on Cox analysis set up nomogram model and use ROC curve to detect this model.Result:Preoperative CT imaging lesion size(p=0.000,HB=0.000,95%CI:1.0151.033),postoperative 1 year lymphocyte by neutrophils ratio(p=0.028,HR=0.028,95%CI:0.917 3.832),postoperative 1 year CEA value(p=0.000,HR=0.000,95%CI:1.002 1.005)and as a significant biomarker to predicting recurrence and/or metastasis of postoperative rectal cancer,The stratified threshold of the lesion size Cut-Point in CT images of patients with rectal cancer was 18.75 cm3,and the Cut-Point value of divide lymphocyte by neutrophils ratio in 1 year after surgery was 0.33,and the CEA Cut-Point after surgery was 16.97 ng/ml.and then,We use LASSO to analysis the value of cut-off with ROC curve which AUC is 0.841.Cox multivariate risk regression results:preoperative CT images in the lesion size(p=0.000,HR=.000,95%CI:0.983--1.011),postoperative 1 year divide lymphocyte by neutrophils(p=0.003,HR=0.003,95%CI:1.58 to 8 16/32-bit),preoperative 1 years CEA values(p=0.000,HR=0.000,95%CI:1.001--1.002).Nomogram model predicts recurrence and metastasis postoperative of rectal cancer AUC as 0.939.Conclusion:Preoperative CT images in the lesion size can predict postoperative recurrence and metastasis of rectal cancer and to analysis it's risk.The postoperative 1 year divide lymphocyte by neutrophils and preoperative 1 year CEA values were also can predict to postoperative tumor recurrence and metastasis risk.