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Prognostic Value of Pretreatment Serum CA199 in Patients with Locally Advanced Rectal Cancer Treated with CRT Followed by TME with Normal Pretreatment Carcinoembryonic Antigen Levels
Digestive Surgery ( IF 1.8 ) Pub Date : 2020-11-10 , DOI: 10.1159/000508442
Daxin Huang 1 , Qingliang Lin 1, 2, 3, 4 , Jianyuan Song 1, 2, 3, 4 , Benhua Xu 5, 6, 7, 8
Affiliation  

Background: Elevated pretreatment carcinoembryonic antigen (CEA) levels are related to poor prognosis in patients with locally advanced rectal cancer (LARC) treated with neo-CRT followed by TME. In patients with normal pretreatment CEA levels, the prognostic significance of carbohydrate antigen 199 (CA199) is controversial. Objectives: The aim of this study was to explore the prognostic value of pretreatment serum CA199 in patients with LARC who had normal pretreatment CEA levels treated with neo-CRT followed by curative surgery. Methods: A retrospective study of 456 patients with LARC treated with neo-CRT followed by TME between January 2006 and May 2017 was performed. We employed the maximal χ2 method to determine the CA199 threshold of 9.1 U/mL based on the difference in survival and divided patients into 2 groups. Group 1: patients with pretreatment s-CEA < 5 ng/mL and CA199 ≥ 9.1 U/mL. Group 2: patients with pretreatment s-CEA < 5 ng/mL and CA199 < 9.1 U/mL. Overall survival (OS) across CA199 was assessed using Cox proportional hazard regression models (PS:CEA ≥ 5 ng/mL was seen as elevated). Results: Multivariate analyses demonstrated that the following factors were significantly related to OS in patients with LARC with normal pretreatment CEA levels: ypT (odds ratio [OR] 1.863, p = 0.030), ypN (OR 1.622, p = 0.026), and pretreatment CA199 levels (OR 1.886, p = 0.048). Conclusion: Pretreatment CA199 is an independent factor for OS in patients with LARC with normal pretreatment CEA levels, which may reach the clinic to guide individualized decision-making.

中文翻译:

治疗前血清 CA199 对接受 CRT 后接受 TME 治疗且治疗前癌胚抗原水平正常的局部晚期直肠癌患者的预后价值

背景:治疗前癌胚抗原(CEA)水平升高与局部晚期直肠癌(LARC)患者接受新 CRT 和 TME 治疗的预后不良有关。在治疗前 CEA 水平正常的患者中,碳水化合物抗原 199 (CA199) 的预后意义存在争议。目的:本研究的目的是探讨治疗前血清 CA199 对治疗前 CEA 水平正常的 LARC 患者的预后价值,这些患者接受新 CRT 后进行治愈性手术。方法:对 2006 年 1 月至 2017 年 5 月期间接受 Neo-CRT 和 TME 治疗的 456 例 LARC 患者进行了回顾性研究。我们采用最大 χ2 方法根据存活率差异确定 9.1 U/mL 的 CA199 阈值,并将患者分为 2 组。第 1 组:治疗前 s-CEA < 5 ng/mL 和 CA199 ≥ 9.1 U/mL 的患者。第 2 组:治疗前 s-CEA < 5 ng/mL 和 CA199 < 9.1 U/mL 的患者。使用 Cox 比例风险回归模型评估 CA199 的总生存期 (OS)(PS:CEA ≥ 5 ng/mL 被视为升高)。结果:多变量分析表明,以下因素与治疗前 CEA 水平正常的 LARC 患者的 OS 显着相关:ypT(比值比 [OR] 1.863,p = 0.030)、ypN(OR 1.622,p = 0.026)和治疗前CA199 水平(OR 1.886,p = 0.048)。结论:治疗前CA199是治疗前CEA水平正常的LARC患者OS的独立影响因素,可进入临床指导个体化决策。5 ng/mL 和 CA199 < 9.1 U/mL。使用 Cox 比例风险回归模型评估 CA199 的总生存期 (OS)(PS:CEA ≥ 5 ng/mL 被视为升高)。结果:多变量分析表明,以下因素与治疗前 CEA 水平正常的 LARC 患者的 OS 显着相关:ypT(比值比 [OR] 1.863,p = 0.030)、ypN(OR 1.622,p = 0.026)和治疗前CA199 水平(OR 1.886,p = 0.048)。结论:治疗前CA199是治疗前CEA水平正常的LARC患者OS的独立影响因素,可进入临床指导个体化决策。5 ng/mL 和 CA199 < 9.1 U/mL。使用 Cox 比例风险回归模型评估 CA199 的总生存期 (OS)(PS:CEA ≥ 5 ng/mL 被视为升高)。结果:多变量分析表明,以下因素与治疗前 CEA 水平正常的 LARC 患者的 OS 显着相关:ypT(比值比 [OR] 1.863,p = 0.030)、ypN(OR 1.622,p = 0.026)和治疗前CA199 水平(OR 1.886,p = 0.048)。结论:治疗前CA199是治疗前CEA水平正常的LARC患者OS的独立影响因素,可进入临床指导个体化决策。多变量分析表明,以下因素与治疗前 CEA 水平正常的 LARC 患者的 OS 显着相关:ypT(比值比 [OR] 1.863,p = 0.030)、ypN(OR 1.622,p = 0.026)和治疗前 CA199 水平(或 1.886,p = 0.048)。结论:治疗前CA199是治疗前CEA水平正常的LARC患者OS的独立影响因素,可进入临床指导个体化决策。多变量分析表明,以下因素与治疗前 CEA 水平正常的 LARC 患者的 OS 显着相关:ypT(比值比 [OR] 1.863,p = 0.030)、ypN(OR 1.622,p = 0.026)和治疗前 CA199 水平(或 1.886,p = 0.048)。结论:治疗前CA199是治疗前CEA水平正常的LARC患者OS的独立影响因素,可进入临床指导个体化决策。
更新日期:2020-11-10
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