Nhận xét giá trị của xét nghiệm CEA trong theo dõi đáp ứng hóa trị ung thư đại trực tràng giai đoạn tái phát, di căn=Predictive value of CEA serum in monitoring chemotherapy response of recurrent and metastatic colorectal cancer patients

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Tác giả: Quốc Hùng Nguyễn, Thị Mai Lan Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.160-167

Bộ sưu tập: Metadata

ID: 478135

Thêm vào giỏ

Tìm hiểu giá trị dự đoán của CEA trong đánh giá đáp ứng với hóa trị ở bệnh nhân ung thư đại trực tràng giai đoạn tái phát, di căn. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu trên bệnh nhân ung thư đại trực tràng giai đoạn tái phát, di căn được điều trị hóa trị từ 1/2018 đến năm 1/2023 tại bệnh viện Ung Bướu Hà Nội. Kết quả: Nghiên cứu thực hiện trên 100 bệnh nhân, trong đó nồng độ CEA cao nhất ở nhóm người bệnh có u nguyên phát ở đại tràng trái (161,8 ng/ml), tuy nhiên sự khác biệt không có ý nghĩa (p>
0,05). Nồng độ CEA cao hơn ở nhóm di căn đa ổ (156,3 ng/ml), ung thư biểu mô tuyến nhầy (303,6 ng/ml) và có mức độ biệt hóa tế bào thấp (319,3 ng/ml), sự khác biệt giữa các nhóm có ý nghĩa (p<
0,05). Giá trị của CEA trong đánh giá bệnh đáp ứng (bao gồm đáp ứng hoàn toàn và đáp ứng một phần) có độ nhạy là 75,8%, độ đặc hiệu 79,8%, giá trị dự báo dương tính 57,4%
giá trị dự báo âm tính 90,1%, và chẩn đoán chính xác là 78,8%. Giá trị của CEA trong đánh giá bệnh tiến triển có độ nhạy là 81,6%, độ đặc hiệu 80,4%
giá trị dự báo dương tính 62,3%
giá trị dự báo âm tính 91,7%, và chẩn đoán chính xác là 80,8%. Kết luận: Việc theo dõi và đánh giá đáp ứng với hóa trị ở bệnh nhân ung thư đại trực tràng bằng CEA là hữu ích, đặc biệt với dự báo nguy cơ bệnh tiến triển.To investigate the predictive value of CEA in assessing response to chemotherapy in patients with recurrent and metastatic colorectal cancer. Subjects and methods: A retrospective descriptive study on patients with recurrent and metastatic colorectal cancer who were treated with chemotherapy from January 2018 to January 2023 at Hanoi Oncology Hospital. Results: 100 patients were included in the study. The highest CEA level was in the group of patients with left colon primary tumor (161.8 ng/ml)
however, the difference was not significant (p>
0.05). The CEA level was higher in the group with multifocal metastasis (156.3 ng/ml), mucinous adenocarcinoma (303.6 ng/ml) and poorly differentiated tumor (319.3 ng/ml), the difference among the groups was significant (p<
0.05). In assessing response (including complete response and partial response), the CEA level has a sensitivity of 75.8%, specificity of 79.8%, positive predictive value of 57.4%, negative predictive value of 90.1%, and diagnostic accuracy of 78.8%. In assessing progression, the CEA level has a sensitivity of 81.6%, specificity of 80.4%, positive predictive value of 62.3%, negative predictive value of 91.7%, and diagnostic accuracy of 80.8%. Conclusion: Using CEA is valuable in monitoring and evaluating chemotherapy response of colorectal cancer patients, especially in predicting the risk of disease progression.

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