血清癌胚抗原、糖类抗原199和反应蛋白联合检测在结直肠癌诊断和预后中的应用价值

Value of combined detection of serum CEA,CA199 and CRP in diagnosis and prognosis of colorectal cancer

目的探讨联合检测血清癌胚抗原（CEA）、糖类抗原199（CA199）和全血C反应蛋白（CRP）在结直肠癌中的诊断和预后价值。方法收集该院于2012~2014年期间接受手术治疗的150例结直肠癌患者作为本次观察主体,其中经病理组织学确诊为结直肠癌且辅助检查确认未发生转移病例97例作为非转移组,初诊时经辅助检查确认已转移病例53例为转移组,同时将同期进行体检的健康者150例设为对照组,对比观察组与对照组以及非转移组与转移组病例初诊手术前与手术并化疗或放疗4个疗程后的血清CEA、血清CA199、全血CRP水平。结果观察组治疗前血清CEA、血清CA199及全血CRP水平明显高于对照组,差异有统计学意义（P〈0.01）,且观察组中转移组各项水平比非转移组高,差异有统计学意义（P〈0.01）;而观察组治疗后血清CEA、CA199、全血CRP均下降,与治疗前相比,差异有统计学意义（P〈0.01）;并且,CEA、CA199、CRP联合检测灵敏度明显高于单一指标,差异有统计学意义（P〈0.01）。结论联合检测血清肿瘤标志物CEA、CA199和全血CRP对结直肠癌的诊断和预后至关重要,有利于结直肠癌的早期诊断和预后评估。

Objective To explore the value of the combined detection of serum CEA,CA199 and CRP in the diagnosis and prognosis of colorectal cancer.Methods Totally 150 patients with colorectal cancer treated in our hospital during 2012-2014 were selected as the observation subjects,including 97 cases of histopathologically diagnosed of colorectal cancer without metastasis verified by the assisted examinations as the non-metastatic group and 53 cases of metastasis verified by the assisted examinations as the metastatic group;at the sametime,80 individuals undergoing the physical examination were taken as the control group.Then the levels of serum CEA,CA199 and whole blood CRP level before surgery and after operation combined with 4courses of chemotherapy or radiotherapy were compared between the observation group and the control group,and between the non-metastatic group and metastatic group.Results The levels of serum CEA,CA199 and whole blood CRP before treatment in the observation group were significantly higher than those in the control group,there was statistically significant difference between two groups（P〈0.01）,moreover the level of each indicator in the metastatic group of the observation group was higher than that in the non-metastatic group,the difference between two groups was statistically significant（P〈0.01）;compared before treatment,the levels of serum CEA,CA199 and whole blood CRP after treatment in the observation group were decreased,the differences between two groups were statistically significant（P〈0.01）;moreover the sensitivity of the combined detection of CEA,CA199,CRP was significantly higher than that of single indicator detection,the difference was statistically significant（P〈0.01）.Conclusion The combined detection of serum CEA,CA199 and whole blood CRP is of great importance for the diagnosis and prognosis of colorectal cancer,which is conducive to the early diagnosis and prognosis evaluation of colorectal cancer.