Clinical application value of CTC combined determination with CEA and CA125 in colorectal cancer

doi:10.3969/j.issn.1673-8640.2021.09.003

Abstract

Abstract:

Objective To investigate the clinical application value of the combined determination of circulating tumor cell（CTC） number,carcinoembryonic antigen（CEA）and carbohydrate antigen（CA）125 in colorectal cancer. Methods A total of 115 patients with colorectal cancer（colorectal cancer group）and 99 patients with colorectal polyps（polyp group）were enrolled. All research subjects were determined for alpha-fetoprotein（AFP）,CEA,CA125,CA19-9,CA15-3,CA72-4 and CTC number. According to CTC number,the patients with colorectal cancer were classified into group Ⅰ（CTC 0/7.5 mL）,group Ⅱ（CTC 1-4/7.5 mL） and group Ⅲ （CTC≥5/7.5 mL）. According to TNM stage of colorectal cancer,the colorectal cancer patients were classified into 0-Ⅱ stage group,Ⅲ stage group and Ⅳ stage group. Logistic regression analysis was used to evaluate the risk factors of colorectal cancer. Receiver operating characteristic（ROC）curve was used to evaluate the value of various indicators in the differential diagnosis of colorectal cancer. Results The levels of serum CEA,CA19-9 and CA72-4 in Ⅰ group were lower than those in Ⅱ group and Ⅲ group（P<0.05）,the level of serum AFP was lower than that in Ⅱ group（P<0.05）,and the level of serum CA125 was lower than that in Ⅲ group（P<0.05）. There was no statistical significance in the indicators between Ⅱ group and Ⅲ group（P>0.05）. There was statistical significance in CTC number and serum CEA,CA125,CA19-9 and CA72-4 levels between polyp group and colorectal cancer group（P<0.05）,while there was no statistical significance in serum AFP and CA15-3 levels among the groups（P>0.05）. There was statistical significance in CA19-9 and CA724 levels between TNM stage 0-Ⅱ group and stage Ⅳ group and between stage Ⅲ group and stage Ⅳ group（P<0.05）. There was statistical significance in CTC number between stage 0-Ⅱ group and stage Ⅳ group（P<0.05）. There was no statistical significance in serum CEA,AFP,CA125 and CA15-3 levels among the 3 groups（P>0.05）. Logistic regression analysis showed that the odds ratios（OR） of CEA,CA125 and CTC number were 1.368,1.135 and 5 560 619.101,respectively. 95% Confidence intervals（CI） were 1.120-1.672,1.037-1.244,0.000-2.129×10²¹⁴,respectively. ROC curve analysis showed that the areas under curves（AUC） of CEA,CA125,CTC number single determinations and combined determination were 0.840,0.741,0.822 and 0.943,respectively. Conclusions The combined determination of CTC number,CEA and CA125 plays a role for patients with colorectal cancer.

Key words: Circulating tumor cell, Carcinoembryonic antigen, Carbohydrate antigen 125, Colorectal cancer

CLC Number:

R446.1

YANG Chaomei, FENG Jie, LANG Lei, YAN Guangtao. Clinical application value of CTC combined determination with CEA and CA125 in colorectal cancer[J]. Laboratory Medicine, 2021, 36(9): 901-905.

Figures/Tables 6

References 16

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组别	例数	性别		年龄/岁		CEA/（U/mL）	AFP/（U/mL）
组别	例数	男/例	女/例	年龄/岁		CEA/（U/mL）	AFP/（U/mL）
Ⅰ组	41	25	16	60.59±9.63		4.65（1.84~14.16）	2.17（1.68~3.26）
Ⅱ组	35	17	18	56.30±12.57		27.49（5.51~375.70）^*	3.13（2.31~3.89）^*
Ⅲ组	39	22	17	58.38±12.41		21.47（4.03~227.60）^*	2.74（1.82~4.35）
统计值		3.298		1.171		0.557	9.850
P值		0.192		0.557		0.000	0.007
组别	CA125/（U/mL）				CA19-9/（U/mL）	CA15-3/（U/mL）	CA72-4/（U/mL）
Ⅰ组	13.05（9.94~21.90）				18.28（6.67~42.63）	9.23（7.07~14.29）	2.05（1.07~4.33）
Ⅱ组	14.13（8.34~32.76）				73.12（8.98~398.10）^*	9.70（8.29~14.52）	12.53（3.83~61.47）^*
Ⅲ组	23.97（12.67~90.73）^*				22.83（12.62~539.50）^*	12.53（8.47~16.11）	27.87（3.61~111.80）^*
统计值	10.786				10.859	3.688	38.526
P值	0.005				0.004	0.158	0.000

组别	例数	性别		年龄/岁		CEA/（U/mL）	AFP/（U/mL）
组别	例数	男/例	女/例	年龄/岁		CEA/（U/mL）	AFP/（U/mL）
Ⅰ组	41	25	16	60.59±9.63		4.65（1.84~14.16）	2.17（1.68~3.26）
Ⅱ组	35	17	18	56.30±12.57		27.49（5.51~375.70）^*	3.13（2.31~3.89）^*
Ⅲ组	39	22	17	58.38±12.41		21.47（4.03~227.60）^*	2.74（1.82~4.35）
统计值		3.298		1.171		0.557	9.850
P值		0.192		0.557		0.000	0.007
组别	CA125/（U/mL）				CA19-9/（U/mL）	CA15-3/（U/mL）	CA72-4/（U/mL）
Ⅰ组	13.05（9.94~21.90）				18.28（6.67~42.63）	9.23（7.07~14.29）	2.05（1.07~4.33）
Ⅱ组	14.13（8.34~32.76）				73.12（8.98~398.10）^*	9.70（8.29~14.52）	12.53（3.83~61.47）^*
Ⅲ组	23.97（12.67~90.73）^*				22.83（12.62~539.50）^*	12.53（8.47~16.11）	27.87（3.61~111.80）^*
统计值	10.786				10.859	3.688	38.526
P值	0.005				0.004	0.158	0.000

组别	例数	CTC/（个/7.5 mL）	CEA/（U/mL）	AFP/（U/mL）
息肉组	99	0.00（0.00~0.00）	1.95（1.23~2.71）	2.81（1.94~3.91）
结直癌组	115	1.00（0.00~6.00）	10.76（2.76~73.99）	2.66（1.83~3.71）
W值		7 573.500	7 054.500	13 938.000
P值		0.000	0.000	0.622
组别	CA125/（U/mL）	CA19-9/（U/mL）	CA15-3/（U/mL）	CA72-4/（U/mL）
息肉组	9.85（7.04~11.57）	9.10（5.64~12.81）	9.51（6.75~12.61）	1.95（1.24~4.67）
结直癌组	15.97（9.98~27.44）	23.93（8.26~96.87）	10.83（7.58~14.85）	5.60（1.51~35.89）
W值	7 907.500	8 001.500	10 350.000	8 941.500
P值	0.000	0.000	0.135	0.000

组别	例数	CTC/（个/7.5 mL）	CEA/（U/mL）	AFP/（U/mL）
息肉组	99	0.00（0.00~0.00）	1.95（1.23~2.71）	2.81（1.94~3.91）
结直癌组	115	1.00（0.00~6.00）	10.76（2.76~73.99）	2.66（1.83~3.71）
W值		7 573.500	7 054.500	13 938.000
P值		0.000	0.000	0.622
组别	CA125/（U/mL）	CA19-9/（U/mL）	CA15-3/（U/mL）	CA72-4/（U/mL）
息肉组	9.85（7.04~11.57）	9.10（5.64~12.81）	9.51（6.75~12.61）	1.95（1.24~4.67）
结直癌组	15.97（9.98~27.44）	23.93（8.26~96.87）	10.83（7.58~14.85）	5.60（1.51~35.89）
W值	7 907.500	8 001.500	10 350.000	8 941.500
P值	0.000	0.000	0.135	0.000

组别	例数	CTC/（个/7.5 mL）	CEA/（U/mL）	AFP/（U/mL）
0~Ⅱ期组	39	0.00（0.00~0.00）	3.90（0.78~20.77）	2.00（1.65~2.68）
Ⅲ期组	35	2.00（0.00~12.00）	5.44（3.51~7.68）	2.74（2.12~3.29）
Ⅳ期组	41	5.00（2.00~13.00）^*	11.81（2.27~129.85）	2.50（1.81~3.84）
统计值		13.052	5.953	3.097
P值		0.001	0.051	0.213
组别	CA125/（U/mL）	CA19-9/（U/mL）	CA15-3/（U/mL）	CA72-4/（U/mL）
0~Ⅱ期组	12.25（8.20~17.46）	9.66（5.76~17.72）	8.96（6.15~12.78）	3.05（1.19~31.63）
Ⅲ期组	11.56（8.02~21.34）	25.61（7.73~29.36）^#	9.45（7.36~15.69）	2.49（1.32~14.39）^#
Ⅳ期组	17.05（10.23~65.60）	37.37（12.06~307.68）^*	9.38（7.02~14.83）	7.26（1.65~51.88）^*
统计值	7.265	10.362	2.070	7.671
P值	0.056	0.006	0.355	0.022