Objective: To investigate the prognostic value of postoperative serum carcinoembryonic antigen(CEA) combined with carbohydrate antigen 19-9(CA19-9), human chondroglycoprotein(YKL-40), C-reactive protein(CRP) and interleukin 6(IL-6) in patients with colorectal cancer(CRC) after radical resection. Methods: A total of 441 CRC patients who received radical surgical treatment in our hospital from January 2010 to February 2017 were selected as the objects of this study. The levels of serum CEA, CA19-9, YKL-40, CRP and IL-6 were measured before adjuvant chemotherapy. The patients were followed up until November 2021 or at the time of death. Cox regression proportional risk model and Kaplan-Meier survival curve were used to analyze the risk factors for postoperative recurrence and survival. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic or prognostic efficacy of serological indicators for CRC. Results: The sensitivity, pecificity and positive predictive value(PPV) of postoperative serum CEA in predicting the recurrence were 21.3%, 90.3% and 80.3% respectively. The sensitivity and PPV of postoperative serum CEA>5 μg·L-1 combined with CA19-9, YKL-40, CRP and IL-6 in predicting the recurrence were increased(P<0.05). For patients with postoperative serum CEA ≤ 5 μg·L-1, 10-year overall survival(OS) and disease-free survival(DFS) of patients with serum YKL-40>77.9 ng·ml-1 were shorter than those with serum YKL-40 ≤ 77.9 ng·ml-1(P<0.05). In addition, the 10-year OS of patients with serum CRP>2.99 mg·L-1 was shorter than that of patients with CRP ≤ 2.99 mg·L-1(P<0.05). The 10-year DFS of patients with serum IL-6>5.4 pg·ml-1 was shorter than that of patients with IL-6 ≤ 5.4 pg·ml-1(P<0.05). Cox regression proportional risk model analysis showed that the increase of CEA, CA19-9, YKL-40 and IL-6 were independent risk factors affecting OS, while the increase of CEA, YKL-40 and IL-6 were independent risk factors affecting DFS(P<0.05). Conclusion: Serum CEA combined with CA19-9, YKL-40, CRP and IL-6 after radical resection can be used as prognostic indicators for colorectal cancer recurrence and survival. |
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