CEA、CA19-9、CA125和CA72-4不同组合在结直肠癌诊断中的临床意义研究

Study on Clinical Significance of Different Combination of CEA,CA19-9,CA125and CA72-4 in Diagnosis of Colorectal Cancer

目的:探讨CEA、CA19-9、CA125和CA72-4不同组合在结直肠癌诊断中的临床意义。方法:回顾性分析分析我院2010年1月-2011年12月确诊的结直肠癌患者373例的临床资料。结果:373例结直肠癌患者中,单一检测CEA、CA19-9、CA125和CA72-4阳性率为24.4%-48.3%,其中CEA阳性率为48.3%,阳性率最高;同时检测两个指标,任一个指标大于正常值的阳性率为38%-55.3%,其中CEA+CA19-9阳性率为55.3%,阳性率最高,与CEA+CA125(阳性率为55%)比较,无统计学意义(P>0.05),与其他组合及单一检测CEA比较有统计学意义;检测三个指标,任一个指标大于正常值的阳性率为46.3%-60.6%,其中CEA+CA19-9+CA125阳性率为60.6%,阳性率最高,与CEA+CA19-9两个指标比较,有统计学意义;同时检测四个指标,任一个指标大于正常值的阳性率为61.2%,虽然比CEA+CA19-9+CA125阳性率高,但无统计学意义。结论:联合检测CEA、CA19-9、CA125和CA72-4可以提高结直肠癌诊断的阳性率,其中联合检测CEA+CA19-9+CA125三个指标是最优组合。

Objective： To investigate the clinical significance of different combination of CEA, CA19-9, CA125 and CA72-4 in the diagnosis of colorectal cancer to find the best combination. Methods： The clinical data of 373 patients with colorectal cancer were retrospectively analyzed from Jan 2010 to Dec 2011. Results： To detect one index, the positive rate of CEA, CA19-9, CA125 and CA72-4 was from 24.4% to 48.3% in 373 patients with colorectal cancer. The positive rate of CEA was 48.3% .It was the highest and had the statistical significance to compare with others. To detect two indexes, the positive rate of any index greater than normal values was from 38% to 55.3%. The positive rate of CEA＋CA19-9 was 55.3%.It was the highest but had not statistical significance to compare with CEA＋CA125 （positive rate 55% ,P 〉 0.05）.There was statistical significance compared with other combination and single detection of CEA. To detect three indexes, the positive rate of any index greater than normal values was from 46.3% to 60.6%. The positive rate of CEA＋CAI9-9＋CA125 was 60.6%. It was the highest and had the statistical significance to compare with other combination and CEA＋CA19-9. To detect four indexes, the positive rate of any index greater than normal values was 61.2% .It was the higher but had not statistical significance to compare with CEA＋CA19-9＋CA125. Conclusion： The combined detection of CEA, CA19-9, CA125 and CA72-4 can improve the positive rate of diagnosis of colorectal cancer. The combined detection of CEA＋CA19-9＋CA125 is the optimal choice.