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首页> 外文期刊>World Journal of Gastroenterology >Cytokeratins and carcinoembryonic antigen in diagnosis, staging and prognosis of colorectal adenocarcinoma.
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Cytokeratins and carcinoembryonic antigen in diagnosis, staging and prognosis of colorectal adenocarcinoma.

机译：细胞角蛋白和癌胚抗原在大肠腺癌的诊断，分期和预后中的作用。

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AIM: To evaluate the serum levels of cytokeratins and carcinoembryonic antigen (CEA) in diagnosis, staging and prognosis of patients with colorectal adenocarcinoma. METHODS: The sample consisted of 169 patients. One hundred blood donors formed the control group. Radical surgery was performed on 120 patients, with an average follow-up duration of 22.3 mo. Relapses occurred in 23 individuals after an average of 18.09 mo. CEA was assayed via the Delfia method with a limit of 5 ng/mL. Cytokeratins were assayed via the LIA-mat TPA-M Prolifigen method with a limit of 72 U/L. RESULTS: In the diagnosis of patients with colorectal adenocarcinoma, CEA showed a sensitivity of 56%, a specificity of 95%, a positive predictive value of 94%, a negative predictive value of 50% and an accuracy of 76.8%. TPA-M had a sensitivity of 70%, a specificity of 96%, a positive predictive value of 97%, a negative predictive value of 66% and an accuracy of 93.6%. The elevation of one of the markers was shown to have a sensitivity of 76.9%, a specificity of 91%, a positive predictive value of 93.5%, a negative predictive value of 70% and an accuracy of 83.6%. There was no variation in the levels of the markers according to the degree of cell differentiation while there was an elevation in their concentrations in accordance with the increase in neoplastic dissemination. There was a statistically significant difference between the patients with stage IV lesions and those with stages I, II and III tumors. With regard to CEA, the average level was 14.2 ng/mL in patients with stage I lesions, 8.5 ng/mL in patients with stage II lesions, 8.0 ng/mL in patients with stage III lesions and 87.7 ng/mL in patients with stage IV lesions. In relation to TPA-M, the levels were 153.1 U/L in patients with stage I tumors, 106.5 U/L in patients with stage II tumors, 136.3 U/L in patients with stage III tumors and 464.3 U/L in patients with stage IV tumors. There was a statistical difference in patients with a high CEA level in relation to a shorter survival (P<0.05). However, there was no correlation between patients with high TPA-M levels and prognostic indices of patients undergoing radical surgery. CONCLUSION: Cytokeratins demonstrate a greater sensitivity than CEA in the diagnosis of colorectal adenocarcinoma. There is an increase in the sensitivity of the markers with tumor dissemination. Cytokeratins cannot identify the worse prognosis in patients undergoing radical surgery. Cytokeratins constitute an advance in the direction of a perfect tumor marker in the treatment of patients with colorectal cancer.
机译：目的：评估血清角蛋白和癌胚抗原（CEA）在大肠腺癌患者的诊断，分期和预后中的作用。方法：该样本包括169例患者。一百个献血者组成对照组。对120例患者进行了根治性手术，平均随访时间为22.3 mo。平均18.09个月后，有23人复发。通过Delfia方法测定的CEA的限量为5 ng / mL。通过LIA-mat TPA-M Prolifigen方法测定细胞角蛋白，限量为72 U / L。结果：在诊断大肠腺癌患者中，CEA的敏感性为56％，特异性为95％，阳性预测值为94％，阴性预测值为50％，准确度为76.8％。 TPA-M的敏感性为70％，特异性为96％，阳性预测值为97％，阴性预测值为66％，准确度为93.6％。显示一种标记物的升高具有76.9％的灵敏度，91％的特异性，93.5％的阳性预测值，70％的阴性预测值和83.6％的准确性。标记物的水平没有根据细胞分化的程度而变化，而随着肿瘤扩散的增加​​，标记物的浓度也有所增加。 IV期病变患者与I，II和III期肿瘤患者之间存在统计学差异。对于CEA，I期病变患者的平均水平为14.2 ng / mL，II期病变患者的平均水平为8.5 ng / mL，III期病变患者的平均水平为8.0 ng / mL，III期病变患者的平均水平为87.7 ng / mL IV病变。与TPA-M相比，I期肿瘤患者的水平为153.1 U / L，II期肿瘤患者的水平为106.5 U / L，III期肿瘤患者的水平为136.3 U / L，III期肿瘤患者的水平为464.3 U / L。 IV期肿瘤。 CEA水平高的患者与生存期短有统计学差异（P <0.05）。但是，TPA-M水平高的患者与接受根治性手术的患者的预后指标之间没有相关性。结论：细胞角蛋白在结直肠腺癌的诊断中具有比CEA更高的敏感性。随着肿瘤扩散标记物的敏感性增加。细胞角蛋白不能确定接受根治性手术的患者预后较差。细胞角蛋白在大肠癌患者的治疗中朝着完美的肿瘤标志物的方向发展。

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