通讯作者: 冯振博, guanghu1963@126.com

DOI：10.12201/bmr.202505.00020

The combined prognostic value of MSI, DD, and CA19-9 in colorectal cancer patients who underwent radical resection

• 摘要：目的 探讨微卫星不稳定性（Microsatellite stability，MSI）、术前 D-二聚体（D-dimer，DD）和CA19-9水平对结直肠癌（colorectal cancer，CRC）根治术患者预后的预测价值。方法 回顾性分析 2020年1月至 2021年12月于广西医科大学第一附属医院及桂林市人民医院行根治性手术的81例CRC患者的一般临床资料、肿瘤组织MSI、术前血浆DD和血清CA19-9水平，筛选影响预后的因素并进行评价。结果 卡方检验结果显示，复发组与无复发组相比，MSI显著降低、术前DD和CA19-9水平显著增高（P均＜0.05）；死亡组与生存组相比，MSI显著降低、术前DD和CA19-9水平显著增高（P均＜0.05）。单因素及多因素分析结果显示，MSI是CRC术后复发的保护因素（P=0.018）、术前DD和CA19-9高表达是CRC术后复发的独立危险因素（P=0.020，P=0.042）；MSI是CRC术后死亡的保护因素（P=0.036），术前DD和CA19-9高表达是CRC术后死亡的独立危险因素（P=0.010，P=0.017）。受试者工作特征曲线（receiver operating characteristic curve，ROC曲线）显示MSI、DD、CA19-9用于预测复发的曲线下面积（AUCROC）分别为0.643、0.599、0.644，MSI、DD、CA19-9单独用于预测死亡的AUCROC分别为0.646、0.642、0.693；三者联合预测复发及死亡的AUCROC分别为0.776、0.825。结论 CRC根治术患者的MSI是预后的保护因素、术前DD和CA19-9高表达是预后的危险因素，三者联合检测能优化CRC根治术预后评估的准确性。

  关键词： MSI；D-二聚体；CA19-9；结直肠癌；预后; ; ; ; 

   

  Abstract: Objective To evaluate the prognostic value of microsatellite instability (MSI), preoperative D-dimer (DD), and CA19-9 level for the prognosis of colorectal cancer (CRC) patients who had undergone radical resection. Methods Retrospectively analyzed the general clinical data, MSI, DD, and CA19-9 levels of 81 CRC patients who underwent radical resection in the First Affiliated Hospital of Guangxi Medical University and Guilin Peoples Hospital between January 2020 and December 2021. Screen and evaluate prognostic factors. Results Chi-square analysis revealed significantly lower MSI and higher preoperative DD/CA19-9 levels in the recurrence group versus non-recurrence group (all P<0.05), with similar patterns observed between death and survival groups (all P<0.05). Univariate and multivariate analyses showed that MSI as a protective factor against recurrence in CRC patients (P=0.018), and high expression of DD and CA19-9 before surgery as independent risk factors for recurrence in CRC patients (P=0.020, P=0.042). MSI as a protective factor against mortality in CRC patients (P=0.036), and high expression of DD and CA19-9 before surgery as independent risk factors for mortality in CRC patients (P=0.010, P=0.017). The ROC curve showed that the AUCROC of MSI, DD, and CA19-9 for predicting recurrence after CRC surgery were 0.643, 0.599, and 0.644 respectively. The AUCROC of MSI, DD, and CA19-9 used alone for predicting mortality were 0.646, 0.642, and 0.693 respectively. The AUCROC of the combined prediction of recurrence and mortality by the three factors were 0.776 and 0.825 respectively. Conclusion MSI is a protective factor for prognosis in CRC patients, whereas high expression of preoperative DD and CA19-9 are risk factors for prognosis. The combined detection of these three factors can optimize the risk stratification of CRC.

  Key words: MSI; D-dimer; CA19-9; Colorectal cancer; Prognosis

  提交时间：2025-05-19

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• 序号	提交日期	编号	操作
  1	2025-03-21	bmr.202505.00020V1	下载

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