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Abstract：
Colorectal cancer (CRC) represents a substantial burden on global healthcare, contributing to significant morbidity and mortality worldwide. Despite advances in screening methodologies, its incidence remains high, necessitating continued efforts in early detection and treatment. Neoplastic invasion and metastasis are primary determinants of CRC lethality, emphasizing the urgency of understanding underlying mechanisms to develop effective therapeutic strategies. This study aimed to explore the potential of serum biomarkers in predicting survival outcomes in CRC patients, with a focus on cathepsin B (CB), leukocytic elastase (LE), total sialic acid (TSA), lipid-associated sialic acid (LASA), antitrypsin activity (ATA), C-reactive protein (CRP), and cystatin C (CC). We recruited 185 CRC patients and 35 healthy controls, assessing demographic variables, tumor characteristics, and 7 serum biomarker levels, including (1) CB, (2) LE, (3) TSA, (4) LASA, (5) ATA, (6) CRP, and (7) CC. Statistical analyses included ANOVA with Tukey\'s post hoc tests and MANOVA for continuous variables. Student\'s t-test was used for dependent samples, while non-parametric tests like Mann-Whitney U and Wilcoxon signed-rank tests were applied for variables deviating from the normal distribution. Categorical variables were assessed using chi-square and Kruskal-Wallis tests. Spearman\'s rank correlation coefficient was utilized to examine variable correlations. Survival analysis employed the Kaplan-Meier method with a log-rank test for comparing survival times between groups. Significant associations were observed between CB (p = 0.04), LE (p = 0.01), and TSA (p = 0.008) levels and survival outcomes in CRC patients. Dukes\' classification stages also showed a significant correlation with survival (p = 0.001). However, no significant associations were found for LASA, ATA, CRP, and CC. Multivariate analysis of LE, TSA, and ATA demonstrated a notable correlation with survival (p = 0.041), notwithstanding ATA\'s lack of significance in univariate analysis (p = 0.13). CB, LE, and TSA emerged as promising diagnostic markers with prognostic value in CRC, potentially aiding in early diagnosis and treatment planning. Further research is needed to validate these findings and explore additional prognostic indicators.
摘要：
结直肠癌（CRC）是全球医疗保健的沉重负担，在世界范围内导致显著的发病率和死亡率。尽管筛查方法取得了进展，它的发病率仍然很高，需要在早期发现和治疗方面继续努力。肿瘤侵袭和转移是CRC致死率的主要决定因素，强调了解制定有效治疗策略的潜在机制的紧迫性。本研究旨在探讨血清生物标志物在预测CRC患者生存结局方面的潜力。以组织蛋白酶B（CB）为重点，白细胞弹性蛋白酶（LE），总唾液酸（TSA），脂质相关唾液酸（LASA），抗胰蛋白酶活性（ATA），C反应蛋白(CRP),和胱抑素C（CC）。我们招募了185名CRC患者和35名健康对照，评估人口统计学变量，肿瘤特征，和7个血清生物标志物水平，包括（1）CB，(2)LE,(3)TSA,(4)LASA,(5)ATA,（6）CRP，（7）CC。统计分析包括方差分析与Tukey的事后检验和连续变量的MANOVA。学生t检验用于依赖样本，而非参数检验如曼-惠特尼U和Wilcoxon符号秩检验适用于偏离正态分布的变量。使用卡方和Kruskal-Wallis检验评估分类变量。利用Spearman的等级相关系数来检验变量相关性。生存分析采用Kaplan-Meier方法和对数秩检验来比较组间的生存时间。观察到CB之间存在显著关联(p=0.04)，LE（p=0.01），和TSA（p=0.008）水平和CRC患者的生存结果。Dukes分类阶段也显示出与生存率显著相关(p=0.001)。然而,LASA没有发现明显的关联,ATA,CRP,CC。LE的多变量分析，运输安全管理局,ATA与生存率有显著相关性(p=0.041)，尽管ATA在单变量分析中缺乏意义(p=0.13)。CB,LE,和TSA成为在CRC中具有预后价值的有希望的诊断标志物，可能有助于早期诊断和治疗计划。需要进一步的研究来验证这些发现并探索其他预后指标。
