Effects of natural orifice transluminal endoscopic radical resection of the colon and targeted therapy on immune response and blood CA199 and CA242 levels in colorectal cancer.

Abstract

To examine the effect of natural orifice transluminal endoscopic radical resection combined with targeted therapy on the immune system and serum levels of CA199 and CA242 in individuals with colorectal cancer. We enrolled 90 patients admitted to our hospital with a diagnosis of colorectal cancer between February 2020 and May 2022 and divided them into 2 groups according to the treatment methods: observation group (n = 45) and control group (n = 45). Patients in the control group underwent conventional laparoscopic radical resection of the colon followed by targeted therapy, whereas those in the observation group underwent natural orifice transluminal endoscopic radical resection of the colon and targeted therapy. Serum CA199 and CA242 levels, incidence of adverse events, clinical efficacy, perioperative indicators, and immune function indicators were compared between the 2 groups. The objective response rate (ORR) and disease control rate (DCR) were significantly higher in the observation group than in the control group (60.00% vs 35.6%, P = .020, and 91.1% vs 64.44%, P = .002, respectively). Compared with the control group, the observation group was associated with less blood loss (P = .003), shorter operation time (P = .011), shorter first exhaust time (P = .042), shorter borborygmus recovery time (P = .042), and shorter length of hospital stay (P = .020). After treatment, the CD3 + (P = .020), CD4 + (P = .008), and CD4+/CD8 + (P = .035) counts were lower, whereas the IgG (P = .014), IgM (P = .019), and IgA (P = .038) counts were higher in the observation group than in the control group. CA199 (P = .009) and CA242 (P = .001) levels were lower in the observation group than in the control group. The groups did not differ significantly in the incidence of adverse events (P = .842). The combination of natural orifice transluminal endoscopic radical resection for colorectal cancer and targeted therapy can shorten hospital stay, improve immune function, lower serum levels of CA199 and CA242, and exhibit good clinical efficacy.