[1]吕彦东,郭书伟,李永胜,等.基于术前CEA和临床病理参数的Ⅰ期结肠癌预后预测模型价值分析[J].陕西医学杂志,2025,54(12):1655-1659,1664.[doi:DOI:10.3969/j.issn.1000-7377.2025.12.011]
　LYU Yandong,GUO Shuwei,LI Yongsheng,et al.Value of a prognostic prediction model for stage Ⅰ colon cancer based on preoperative CEA and clinical pathological parameters[J].,2025,54(12):1655-1659,1664.[doi:DOI:10.3969/j.issn.1000-7377.2025.12.011]
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基于术前CEA和临床病理参数的Ⅰ期结肠癌预后预测模型价值分析

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年12期
页码:
1655-1659,1664
栏目:
临床研究
出版日期:
2025-12-05

文章信息/Info

Title:
Value of a prognostic prediction model for stage Ⅰ colon cancer based on preoperative CEA and clinical pathological parameters
作者:
吕彦东1; 郭书伟1; 李永胜1; 姚运壮2; 范海鹏1; 卢义康1; 刘洪洲1
（1.长治医学院附属和平医院结直肠外科，山西 长治 046000；2.长治医学院附属和平医院消化内科，山西 长治 046000）
Author(s):
LYU Yandong1; GUO Shuwei1; LI Yongsheng1; YAO Yunzhuang2; FAN Haipeng1; LU Yikang1; LIU Hongzhou1
(1.Department of Colorectal Surgery,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China;2.Department of Gastroenterology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China)
关键词:
结肠癌; Ⅰ期; 癌胚抗原; 预后; 影响因素; 预测模型
Keywords:
Colon cancer; Phase Ⅰ; Carcinoembryonic antigen; Prognosis; Influencing factors; Prediction model
分类号:
R 735.35
DOI:
DOI:10.3969/j.issn.1000-7377.2025.12.011
文献标志码:
A
摘要:
目的：探究基于术前癌胚抗原（CEA）和临床病理参数的Ⅰ期结肠癌预后预测模型的价值。方法：选取196例Ⅰ期结肠癌病历资料实施回顾性研究，按5年生存状况分为生存组和死亡组。通过Cox回归分析Ⅰ期结肠癌预后影响因素；采用Kaplan-Meier生存曲线分析术前CEA>50 ng/ml和≤50 ng/ml患者生存状况；根据影响因素构建预测模型，并通过受试者工作特征（ROC）曲线分析预测模型数对Ⅰ期结肠癌预后的预测价值。结果：随访5年，196例Ⅰ期结肠癌患者中，生存158例（生存组），病死38例（死亡组）。两组年龄、脉管浸润、肠穿孔、术前血红蛋白、术前白蛋白、术前血小板、术前CA199水平、术前CEA水平比较差异有统计学意义（均P<0.05）。Cox回归分析显示，脉管浸润、肠穿孔、术前CA199（>37 U/ml）、术前CEA（>50 ng/ml）是Ⅰ期结肠癌预后的危险因素（均P<0.05）。术前CEA>50 ng/ml患者生存时间低于术前CEA≤50 ng/ml患者（P<0.05）。Kaplan-Meier生存曲线分析显示，术前CEA≤50 ng/ml患者生存状况高于术前CEA>50 ng/ml患者（P<0.05）。将脉管浸润、肠穿孔、术前CA199、术前CEA纳入回归方程，得出模型数据（预测模型=10.056×脉管浸润＋4.325×肠穿孔＋1.661×术前CA199＋1.882×术前CEA）。ROC曲线分析显示预测模型对Ⅰ期结肠癌预后的预测价值高于单项指标（均P<0.05）。结论：脉管浸润、肠穿孔、术前CA199>37 U/ml、术前CEA>50 ng/ml是 Ⅰ期结肠癌预后的危险因素，术前CEA≤50 ng/ml患者生存状况高于术前CEA>50 ng/ml患者，基于上述危险因素构建的预测模型对Ⅰ期结肠癌预后具有良好的预测价值。
Abstract:
Objective:To explore the value of a prognostic prediction model for stage Ⅰ colon cancer based on preoperative carcinoembryonic antigen (CEA) and clinical pathological parameters.Methods：A retrospective study was conducted on the medical records of 196 patients with stage Ⅰ colon cancer,and they were divided into survival group and death group according to their 5-year survival status.Cox regression analysis was used to identify the prognostic factors for stage Ⅰ colon cancer;the survival status of patients with preoperative CEA >50 ng/ml and ≤50 ng/ml was analyzed using the Kaplan-Meier survival curve;a prediction model was constructed based on the prognostic factors,and the predictive value of the model for the prognosis of stage Ⅰcolon cancer was analyzed using ROC curve.Results:After 5-year follow-up,among 196 patients with stage Ⅰ colon cancer,158 survived (survival group),and 38 died (death group).There were statistically significant differences in age,vascular invasion,intestinal perforation,preoperative hemoglobin,preoperative albumin,preoperative platelet count,preoperative CA199 level,and preoperative CEA level between the two groups (all P<0.05).Cox regression analysis showed that vascular invasion,intestinal perforation,preoperative CA199 (> 37 U/ml),and preoperative CEA (> 50 ng/ml) were risk factors for the prognosis of stage Ⅰ colon cancer (all P<0.05).Patients with preoperative CEA >50 ng/ml had a shorter survival time than those with preoperative CEA ≤50 ng/ml (P<0.05).Kaplan-Meier survival curve analysis showed that the survival status of patients with preoperative CEA ≤50 ng/ml was higher than that of patients with preoperative CEA >50 ng/ml (P<0.05).Vascular invasion,intestinal perforation,preoperative CA199,and preoperative CEA were included in the regression equation,and the model data were obtained (prediction model=10.056×vascular invasion＋4.325×intestinal perforation＋1.661×preoperative CA199＋1.882×preoperative CEA).ROC curve analysis showed that the prediction model had a higher predictive value for the prognosis of stage Ⅰ colon cancer than individual indicators (all P<0.05).Conclusion:Vascular infiltration,intestinal perforation,preoperative CA199 >37 U/ml,and preoperative CEA >50 ng/ml are risk factors for the prognosis of stage Ⅰ colon cancer.Patients with preoperative CEA ≤50 ng/ml have a better survival status than those with preoperative CEA >50 ng/ml.The prediction model constructed based on these risk factors has good predictive value for the prognosis of stage Ⅰ colon cancer.

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备注/Memo

备注/Memo:
山西省重点研发计划项目（2023WJK-1062）
更新日期/Last Update: 2025-12-05