粪便钙卫蛋白检测诊断结直肠癌87例

Diagnosis of colorectal cancer by faecal calprotectin:an analysis of 87 cases

目的:比较粪便钙卫蛋白、便潜血试验及血清CEA在结直肠癌诊断中的应用价值.方法:研究组共纳入肠镜证实的87例结直肠癌初诊患者,对照组60例接受肠镜检查的健康成人.所有研究对象在接受肠镜检查时留取大便标本,检测便潜血及粪便钙卫蛋白,肠镜检查后抽取静脉血4mL,用于检测血清CEA.随访患者手术记录及手术病理.结果:粪便钙卫蛋白、便潜血试验及血清CEA诊断结直肠癌的敏感性分别为88.51%、83.91%和44.83%,特异性分别为88.33%、96.67%和93.33%.Dukes分期为A和B期患者便潜血试验及血清CEA的阳性率明显低于C和D期患者(P=0.0173,0.0059),Dukes不同分期的患者中,粪便钙卫蛋白的阳性率无明显差异;不同部位的结直肠癌与粪便钙卫蛋白、大便潜血试验及血清CEA的阳性率无显著差异;钙卫蛋白联合应用FOBT或/和CEA检测结直肠癌可以一定限度地提高其敏感性,但三种联合检测组合较单用粪便钙卫蛋白检测均无显著性差异.结论:粪便钙卫蛋白检测结直肠癌有较高的敏感性,且不受肿瘤分期的影响,可以作为门诊筛查结直肠癌的标志物.

AIM： To explore the values of faecal calprotectin, faecal occult blood tests and serum carcinoembryonic antigen （CEA） in the diagnosis of colorectal cancer. METHODS： Faecal calprotectin, faecal occult blood and serum CEA were detected in 60 healthy adults and 87 patients with colorectal cancer. Tumor location and Dukes＇ stages were obtained from postoperative pathological examination. RESULTS： The sensitivities of faecal calprotectin, faecal occult blood test and serum CEA were 88.51%, 83.91% and 44.83%, respectively, in the diagnosis of colorectal cancer, while the specificities were 88.33, 96.67% and 93.33, respectively. The positive rates of faecal occult blood test and serum CEA in patients with Dukes＇ stage C and D were significantly higher than those in patients with Dukes＇ stage A and B （P = 0.0173, 0.0059）. There was no significant difference in faecal calprotectin level in patients with different tumor locations and Dukes＇ stages. Faecal calprotectin in combination with FOBT and/or CEA demonstrated a little higher sensitivity. CONCLUSION： Faecal calprotectin is sensitive in the diagnosis of colorectal cancer, and can be used as a non-invasive surrogate marker for screening colorectal cancer in outpatients.