血清癌胚抗原及大便隐血试验诊断大肠癌价值

Efficiency of fecal occult blood test and carcinoembryonic antigen in diagnosing colorectal carcinoma

目的:评价大便隐血试验、血清癌胚抗原在早期大肠癌诊断中的价值。方法:回顾性分析173例大肠癌患者(大肠癌组),327例结肠息肉患者、126例胃癌患者、96例胃息肉患者、182例消化道溃疡患者及150例胃炎患者(对照组)的大便隐血试验及血清癌胚抗原检测结果,对上述指标在大肠癌筛查中的敏感度和特异度进行统计学分析。结果:在大肠癌诊断中,单独应用大便隐血试验的敏感度为50.9%,特异度为86.8%,Youden指数仅为37.7%;单独应用癌胚抗原的敏感度为39.3%,特异度为94.2%,Youden指数仅为33.5%。联合应用大便隐血试验+癌胚抗原的敏感度为69.9%,特异度为83.7%,Youden指数为53.6%。结论:血清癌胚抗原和大便隐血试验对晚期大肠癌的诊断有一定价值,但单项应用诊断早期大肠癌的准确率偏低。联合应用可提高大肠癌诊断敏感度,但总体检测效率仍偏低。

Objective To evaluate the value of fecal occult blood test and serological tumor markers carcinoembryonic antigen to the diagnosis of early stage colorectal carcinoma.Methods The results of fecal occult blood test and carcinoembryonic antigen detection were retrospectively studied in 173 patients with colorectal cancer,327 patients with colonic polyp,126 patients with gastric carcinoma,96 patients with gastric polyp,182 patients with peptic ulcer and 150 patients with gastritis.The sensitivity and specificity were statistically analyzed.Results The sensitivity,specificity and Youden index in diagnosing colorectal carcinoma were 50.9%,86.8% and 37.7% with fecal occult blood test,39.93%,94,2% and 33.5% with carcinoembryonic antigen detection,and 69.9%,83.7% and 53.6% with the combination method.Conclusion Fecal occult blood test and carcinoembryonic antigen have a diagnostic value to advanced colorectal carcinoma.The efficiency of fecal occult blood test or carcinoembryonic antigen detection is low in diagnosing early stage colorectal carcinoma.The combination of these two methods can improve the sensitivity in diagnosing colorectal carcinoma,and the total detection rate is low.