结直肠癌患者癌胚抗原的影响因素分析OA
Analysis of the influencing factors of carcinoembryonic antigen in patients with colorectal cancer
目的 探讨结直肠癌患者癌胚抗原(CEA)的影响因素.方法 选取 2021 年 1 月至 2023 年 12 月牡丹江医科大学附属红旗医院、佳木斯大学附属第一医院、齐齐哈尔医学院附属第三医院收治的 180 例结直肠癌患者作为研究对象,采用酶联免疫吸附法检测血清 25-羟维生素、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平;化学发光法检测 CEA、糖类抗原 199(CA19-9)、糖类抗原 724(CA72-4)水平;双抗体夹心法检测胰岛素样生长因子结合蛋白 3(IGFBP3)水平.以 CEA 为因变量,各项血清学指标、临床病理特征(含维生素 D 摄入史)等为自变量进行单因素分析及多因素线性回归分析.结果 单因素分析显示,肿瘤直径≥5 cm、有淋巴结转移、TNM分期Ⅲ～Ⅳ期、年龄≥60 岁、体重指数(BMI)≥24 kg/m2、维生素 D 摄入不足的患者 CEA 水平高于对照组,差异有统计学意义(P＜0.05);男女患者 CEA水平比较,差异无统计学意义(P＞0.05).相关性分析显示,CEA与 25-羟维生素、IGFBP3 呈负相关,与 CA199、CA724 呈正相关(P＜0.05),与 TNF-α、IL-6 无相关性(P＞0.05).多因素分析结果显示,25-羟维生素(B=-0.523,t=5.500,95%CI:-0.715～-0.331)、TNM分期(B=1.852,t=3.891,95%CI:0.946～2.758)、肿瘤直径(B=1.246,t=3.124,95%CI:0.458～2.034)、淋巴结转移(B=1.083,t=2.876,95%CI:0.321～1.845)、年龄(B=0.864,t=2.621,95%CI:0.213～1.515)、BMI(B=0.635,t=2.185,95%CI:0.102～1.168)是结直肠癌患者 CEA 的独立影响因素(P＜0.05).结论 血清 25-羟维生素水平与结直肠癌患者 CEA 表达呈负相关,可能通过调控 IGF 信号通路参与肿瘤进展,具备作为 CEA 相关辅助监测指标的潜力;TNM 分期、肿瘤直径、淋巴结转移、年龄、BMI 亦为 CEA的独立影响因素,可为结直肠癌诊疗与预后评估提供参考.
Objective To explore the influencing factors of carcinoembryonic antigen(CEA)in patients with colorectal can-cer.Methods A total of 180 patients with colorectal cancer who were admitted to Hongqi Hospital Affiliated to Mudanjiang Medical University,Jiamusi University Affiliated First Hospital,and Qiqihar Medical University Affiliated Third Hospital from January 2021 to December 2023 were selected as the research subjects.The levels of serum 25-hydroxyvitamin,tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were detected by enzyme-linked immunosorbent assay;the levels of CEA,carbohydrate antigen 199(CA19-9),and carbohydrate antigen 724(CA72-4)were detected by chemiluminescence method;and the level of insulin-like growth factor bindin g protein 3(IGFBP3)was detected by double-antibody sandwich method.CEA was used as the dependent variable,and various serological indicators,clinical pathological features(including vitamin D intake history)and other factors were used as independent variables for univariate analysis and multivariate linear regression analysis.Results The single-factor analysis showed that patients with tumor diameter≥5 cm,lymph node metastasis,TNM stage Ⅲ-Ⅳ,age≥60 years,body mass index(BMI)≥24 kg/m2,and insufficient vitamin D intake had higher CEA levels than the control group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in CEA levels between male and female patients(P＞0.05).Cor-relation analysis showed that CEA was negatively correlated with 25-hydroxyvitamin and IGFBP3,positively correlated with CA19-9 and CA72-4(P＜0.05),and had no correla-tion with TNF-α and IL-6(P＞0.05).The results of mul-tivariate factor analysis showed that 25-hydroxyvitamin(B=-0.523,t=5.500,95%CI:-0.715--0.331),TNM stage(B=1.852,t=3.891,95%CI:0.946-2.758),tumor diameter(B=1.246,t=3.124,95%CI:0.458-2.034),lymph node metastasis(B=1.083,t=2.876,95%CI:0.321-1.845),age(B=0.864,t=2.621,95%CI:0.213-1.515),and BMI(B=0.635,t=2.185,95%CI:0.102-1.168)were independent influencing factors of CEA in patients with colorectal cancer(P＜0.05).Conclusion The serum 25-hydroxyvitamin level was negatively correlated with the expression of CEA in patients with colorectal cancer.It may participate in tumor progression by regulating the IGF signaling pathway and has the potential to be used as an auxiliary monitoring indicator related to CEA.TNM stage,tumor diameter,lymph node metastasis,age,and BMI were also independent influencing factors of CEA and could provide references for the diagnosis,treatment,and prognosis assessment of colorectal cancer.
宋传芳;艾江;张杰;孙哲宇;陈爱东
牡丹江医科大学附属红旗医院消化内科,黑龙江 牡丹江 157000牡丹江医科大学附属红旗医院消化内科,黑龙江 牡丹江 157000牡丹江医科大学附属红旗医院消化内科,黑龙江 牡丹江 157000牡丹江医科大学附属红旗医院消化内科,黑龙江 牡丹江 157000牡丹江医科大学附属红旗医院消化内科,黑龙江 牡丹江 157000
医药卫生
结直肠癌血清25-羟维生素D肿瘤标志物胰岛素样生长因子结合蛋白3
Colorectal cancerSerum 25-hydroxyvitamin DTumor markersInsulin-like growth factor binding protein 3
《中国当代医药》 2026 (13)
56-60,5
黑龙江省卫生健康委科研课题项目(20210303030277).
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