作者：张莉莉1，张学良2

单位：1.南通第三人民医院 肿瘤内科， 江苏 南通 226021;  2.南通市肿瘤医院 胃肠外科， 江苏 南通 226001

Authors: Zhang Lili1，Zhang Xueliang2

Unit: 1.Department of Oncology，Nantong Third People’s Hospital，Nantong 226021，Jiangsu，China;  2.Department of Gastrointestinal Surgery，Nantong Cancer Hospital，Nantong 226021，Jiangsu，China

摘要：

目的 探讨结直肠癌患者细胞角蛋白19片段抗原(CYFRA21-1)、糖类抗原125(CA125)水平与奥沙利铂、亚叶酸钙、氟尿嘧啶(FOLFOX)联合化疗方案化疗疗效的关系。方法 选取南通市肿瘤医院2019年1月至2020年6月肿瘤内科住院部收治的结直肠癌患者98例。全部患者均采用FOLFOX方案(奥沙利铂100 mg/m2，第1天；四氢叶酸200 mg/m2+氟尿嘧啶500 mg/m2，第1～5天)进行化疗，4周1个疗程，共6个疗程。化疗结束后持续随访12个月，以有效率作为主要疗效指标，以无进展生存(PFS)期、总生存(OS)期作为次要疗效指标。采用放射免疫法检测治疗前后血清CYFRA21-1、CA125水平。采用配对t检验分析治疗前后上述血清指标水平的差异，结合Spearman及Pearson相关性分析血清CYFRA21-1、CA125治疗前后差值与化疗疗效的关系。结果 治疗后，结直肠癌患者血清CYFRA21-1、CA125水平分别为(5.84±0.57)μg/L、(56.55±4.50)U/ml，治疗后血清指标明显高于治疗前的(2.99±0.48)μg/L、(38.36±4.55)U/ml(均P<0.05)。98例患者中，有效率为41.8%,PFS期为(16.47±3.15)个月，OS期为(29.03±6.10)个月，CYFRA21-1治疗前后差值为(2.85±0.69)μg/L,CA125治疗前后差值为(18.18±5.69)U/ml。Spearman相关性分析显示，治疗前CA125水平与有效率正相关(r=0.514,P<0.05)，而治疗后CA125、CA125治疗前后差值与有效率负相关(r=-0.513/-0.808,P<0.05)。Pearson相关性分析显示，CYFRA21-1、CA125与PFS期、OS期无明显相关性(P>0.05)。结论 结直肠癌患者CYFRA21-1、CA125水平变化程度与FOLFOX化疗疗效相关，监测治疗前后CYFRA21-1、CA125水平变化可能为疗效评价提供指导。 

关键词：结直肠癌； 细胞角蛋白19片段抗原； 糖类抗原125； FOLFOX化疗方案

Abstract：

Objective To investigate the relationship between CYFRA21-1，CA125 and the efficacy of FOLFOX chemotherapy in patients with colorectal cancer. Method A total of 98 patients with colorectal cancer admitted to the inpatient department of Medical Oncology in Nantong Cancer Hospital from January 2019 to June 2020 were selected as the study subjects. All patients were given FOLFOX regimen chemotherapy （oxaliplatin 100 mg/m2，d1; tetrahydrofolic acid 200 mg/m2+ fluorouracil 500 mg/m2，d1-5） for 4 weeks/cycle of，a total of 6 cycles. The patients were followed up for 12 months since chemotherapy. And PFS was as the primary efficacy index，OS was as the secondary efficacy index. The levels of serum CYFRA21-1 and CA125 before and after treatment were detected by radioimmunoassay. The differences in the levels of above serum indicators before and after treatment was analyzed by paired T test ，and the relationship between serum CyFRA21 -1，CA125 and chemotherapy efficacy was analyzed by Spearman and Pearson correlation. Result After treatment，the levels of CYFRA21-1 and CA125 in colorectal cancer patients were respectively（5.84 ±0.57）μg/L and （56.55 ±4.50）U/ml，which were significantly higher than those before treatment of（2.99±0.48）μg/L，（38.36±4.55）U/ml，P<0.05. In the 98 cases，efficient rate was 41.8%，PFS was （16.47±3.15），OS was（29.03±6.10），and the CYFRA21-1 difference was （2.85±0.69）μg/L，CA125 difference was （18.18±5.69）U/ml. Spearman correlation analysis revealed a significant positive correlation between pretreatment CA125 levels and efficiency（r=0.514，P<0.05），and CA125 of post-therapy and difference was negatively correlative with efficiency （r =-0.513/-0.808，P <0.05）. Pearson correlation analysis showed no significant correlation between CYFRA21-1，CA125 and PFS，OS（P>0.05）. Conclusion The changes of cyFRA21-1 and CA125 levels in colorectal cancer patients are closely related to the efficacy of FOLFOX chemotherapy ，and monitoring the above indicators can provide important guidance for the efficacy evaluation.

Key Words:  Colorectal cancer; CYFRA21-1; Carbohydrate antigen 125; FOLFOX chemotherapy regimen