Analysis Of The Predictive Value Of Serum CEA And CA19-9 For Visceral Metastasis Of Stage Ⅱ And Ⅲ Colorectal Cancer

Objective: To explore the predictive value of CEA and CA19-9 levels in the future visceral metastasis of stage Ⅱ and Ⅲ colorectal cancer and the influencing factors of visceral metastasis.Methods: The clinicopathological data and serum CEA and ca19-9 levels of 122 patients with stage Ⅱ and Ⅲ CRC admitted to shengjing hospital affiliated to China medical university from January 2011 to December 2015 were retrospectively collected,and their subsequent liver,lung and peritoneal metastases were statistically analyzed through follow-up observation.Results: 1.Independent risk factors for CRC visceral metastasis were gender,preoperative serum CEA level and post-operative stage.2.The area under the ROC curve of liver metastasis,lung metastasis and peritoneal metastasis predicted by CEA was 0.768,0.681 and 0.596,respectively.Taking 5ng/ml as the critical value of CEA,the sensitivity,specificity,positive predictive value and negative predictive value of predicting CRC liver metastasis were 67.9%,77.0%,57.6%,83.9% and 74.2%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of CRC lung metastasis were 58.8%,77.0%,41.7%,87.0% and 73.1%,respectively.3.The area under the ROC curve of ca19-9 in predicting liver metastasis,lung metastasis and peritoneal metastasis was 0.567,0.544 and 0.744,respectively.Using 37u/ml as the critical value of ca19-9,the sensitivity,specificity,positive predictive value and negative predictive value of CRC peritoneal metastasis were predicted,with an accuracy of 43.8%,95.1%,70.0%,86.6% and 84.4%.4.The area under ROC curve of CEA and CA19-9 for predicting CRC visceral metastasis was 0.800 and 0.688,respectively.The accuracy of predicting CRC visceral metastasis was 68.0% and 62.3%,respectively.Coclusion: 1.Male,preoperative serum CEA level and postoperative stage were independent risk factors for future visceral metastasis of CRC.2.CEA has moderate predictive value for CRC liver metastasis,and provides certain diagnostic basis for lung metastasis,but has no predictive value for peritoneal metastasis.3.CA19-9 has has moderate predictive value for CRC peritoneal metastasis.It may be a useful index for predicting peritoneal metastasis of CRC,but it has no predictive value for lung metastasis and liver metastasis.4.For patients with simultaneous elevation of CEA and ca19-9,we should pay more attention to the presence of visceral metastasis during follow-up.