消化道疾病血清CRP与肿瘤标志物的联合检测意义

The Clinical value of Combined Detection of Serum CRP and Tumor Markers in the Digestive Diseases

目的探讨消化系统恶性肿瘤和良性炎症疾病手术前后CRP与CEA、AFP、CA125、CA19-9联合检测的临床意义。方法对76例健康体检者7、9例良性消化化道疾病患者、146例恶性消化道疾病患者进行了手术前后血清CRP和CEA、CA19-9、CA125和AFP检测。结果术前恶性肿瘤组CRP、CEA、AFP、CA125和CA19-9均显高于对照组;良性组CRP明显高于对照组,CEA、AFP、CA125、CA19-9与对照组没有明显差别:恶性肿瘤组CRP明显低于良性病变组CRP,但恶性肿瘤组CEA、AFP、CA125、CA19-9明显高于良性端病变组。术后恶性肿瘤CRP降低缓慢同时恶性四种肿瘤标记物血清浓度均有下降的趋势(其中肝癌中术后CA19-9,CA125及AFP浓度,大肠癌术后CEA和胰腺癌术后CA19-9的浓度降低有统计学差异);良性消化道疾手术一周后,四种肿瘤标记物血清浓度无下降的趋势。结论CRP在恶性消化道肿瘤的早期诊断和与良性消化道疾病鉴别方面有一定的价值;联合检测患者血清的CRP、CEA、AFP、CA125、CA19-9在消化系统疾病诊断和治疗监测中具有显著的互补性。

Objective To explore the Clinical value of pre-and pro-operative combined detection of serum CEA、AFP、CA125、CA19-9 tumor markers and CRP inflammatory maker in patients with malignant and benign inflammatory diseases of digestive system.Methods 146 cases with malignant tumor of digestive system,79 cases with benign inflammatory diseases of digestive system and 76 cases as control person were selected.We detected the concentration of the tumor marker CEA、AFP、CA125、CA19-9 levels by the Chem-iluminescent immunoassay,CRP detected by the Immunonephelometry.Results There was signincant diffierence in CRP、CEA、AFP、CA125、CA19-9 levels between malignant tumor group and innammatory diseases group before surgery operation.CRP levels in Benign inflammatory group was signincant higher than that in control(P<0.05),and there was no signincant difference in pre-operational CEA、AFP、CA125、CA19-9 levels between them(P>0.05).Meanwhile,the CRP level in benign group was higher in malignant tumor group(P<0.05),lower in CEA、AFP、CA125、CA19-9 levels(P>0.05).On the 7th post-operatlve day,the positive rate of CRP concerttration in tumor group was higher than in benign group(P<0.05).Conclusion The comblned detection of CRP、CEA、AFP、CA125、CA19-9 was helpful for diagnosis of malignant tumor of digestive system.They can be supplemented with each other.