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Abstract：
BACKGROUND: In recent years, the incidence of colorectal cancer (CRC) has been increasing. With the popularization of endoscopic technology, a number of early CRC has been diagnosed. However, despite current treatment methods, some patients with early CRC still experience postoperative recurrence and metastasis.
OBJECTIVE: To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.
METHODS: A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study. Results of blood routine test, liver and kidney function tests and tumor markers were collected before surgery. Patients were followed up through disease-specific database and telephone interviews. Tumor recurrence, metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.
RESULTS: We comprehensively compared the predictive value of preoperative blood routine, blood biochemistry and tumor markers for disease-free survival (DFS) and overall survival (OS) of CRC. Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS [hazard ratio (HR) = 0.995, 95% confidence interval (CI): 0.991-0.999, P = 0.015], while serum carcinoembryonic antigen (CEA) level (HR = 1.008, 95%CI: 1.001-1.016, P = 0.027) and serum total cholesterol level (HR = 1.538, 95%CI: 1.026-2.305, P = 0.037) were independent risk factors for OS. The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL. Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level, the difference between the two groups was not statistically significant (P = 0.075).
CONCLUSIONS: For patients with T2N0M0 or T3N0M0 CRC, preoperative platelet count was a protective factor for DFS, while serum CEA level was an independent risk factor for OS. Given that these measures are easier to detect and more acceptable to patients, they may have broader applications.
OBJECTIVE: To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.
METHODS: A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study. Results of blood routine test, liver and kidney function tests and tumor markers were collected before surgery. Patients were followed up through disease-specific database and telephone interviews. Tumor recurrence, metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.
RESULTS: We comprehensively compared the predictive value of preoperative blood routine, blood biochemistry and tumor markers for disease-free survival (DFS) and overall survival (OS) of CRC. Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS [hazard ratio (HR) = 0.995, 95% confidence interval (CI): 0.991-0.999, P = 0.015], while serum carcinoembryonic antigen (CEA) level (HR = 1.008, 95%CI: 1.001-1.016, P = 0.027) and serum total cholesterol level (HR = 1.538, 95%CI: 1.026-2.305, P = 0.037) were independent risk factors for OS. The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL. Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level, the difference between the two groups was not statistically significant (P = 0.075).
CONCLUSIONS: For patients with T2N0M0 or T3N0M0 CRC, preoperative platelet count was a protective factor for DFS, while serum CEA level was an independent risk factor for OS. Given that these measures are easier to detect and more acceptable to patients, they may have broader applications.
摘要：
背景：近年来，结直肠癌（CRC）的发病率一直在增加。随着内镜技术的普及,已经诊断出许多早期CRC.然而,尽管目前的治疗方法，部分早期CRC患者术后仍有复发和转移.
目的：寻找与早期CRC复发和转移相关的指标，以识别高危人群。
方法：本研究回顾性纳入了513例pT2N0M0或pT3N0M0CRC患者。血常规检查结果,术前收集肝肾功能检查和肿瘤标志物。通过疾病特异性数据库和电话访谈对患者进行随访。肿瘤复发，以转移或死亡为研究终点,寻找与早期CRC复发和转移相关的危险因素和预测价值。
结果：我们综合比较了术前血常规的预测价值，血液生物化学和肿瘤标志物用于CRC的无病生存期（DFS）和总生存期（OS）。Cox多变量分析表明，低血小板计数与不良DFS显着相关[风险比（HR）=0.995，95％置信区间（CI）：0.991-0.999，P=0.015]。血清癌胚抗原(CEA)水平(HR=1.008,95CI:1.001~1.016,P=0.027)和血清总胆固醇水平(HR=1.538,95CI:1.026~2.305,P=0.037)是OS的独立危险因素。血清CEA水平预测OS的截断值为2.74ng/mL。尽管血清CEA高于临界值的CRC患者的OS比CEA水平较低的患者差。两组比较差异无统计学意义(P=0.075)。
结论：对于T2N0M0或T3N0M0CRC患者，术前血小板计数是DFS的保护因素,血清CEA水平是OS的独立危险因素。鉴于这些措施更容易发现，患者也更容易接受，它们可能有更广泛的应用。
目的：寻找与早期CRC复发和转移相关的指标，以识别高危人群。
方法：本研究回顾性纳入了513例pT2N0M0或pT3N0M0CRC患者。血常规检查结果,术前收集肝肾功能检查和肿瘤标志物。通过疾病特异性数据库和电话访谈对患者进行随访。肿瘤复发，以转移或死亡为研究终点,寻找与早期CRC复发和转移相关的危险因素和预测价值。
结果：我们综合比较了术前血常规的预测价值，血液生物化学和肿瘤标志物用于CRC的无病生存期（DFS）和总生存期（OS）。Cox多变量分析表明，低血小板计数与不良DFS显着相关[风险比（HR）=0.995，95％置信区间（CI）：0.991-0.999，P=0.015]。血清癌胚抗原(CEA)水平(HR=1.008,95CI:1.001~1.016,P=0.027)和血清总胆固醇水平(HR=1.538,95CI:1.026~2.305,P=0.037)是OS的独立危险因素。血清CEA水平预测OS的截断值为2.74ng/mL。尽管血清CEA高于临界值的CRC患者的OS比CEA水平较低的患者差。两组比较差异无统计学意义(P=0.075)。
结论：对于T2N0M0或T3N0M0CRC患者，术前血小板计数是DFS的保护因素,血清CEA水平是OS的独立危险因素。鉴于这些措施更容易发现，患者也更容易接受，它们可能有更广泛的应用。
