血清TNF-α、CEA、CA242联合检测对直肠癌诊疗的临床价值

Clinical value of combined detection of serum TNF-α,CEA and CA242 for rectal cancer

目的 动态观察血清肿瘤坏死因子-α（TNF-α）、癌胚抗原（CEA）、糖链抗原242（CA242）在直肠癌（RC）患者手术前后的含量变化,探讨其联合检测在RC诊断、疗效判定及病情监测中的临床价值。方法 选取2014年1-6月于西南医科大学附属医院胃肠外科住院治疗的直肠疾病患者共60例,其中30例RC患者（A组）、30例直肠良性疾病患者（B组）,选择同一时间段内来该院体检的健康人员30例（C组）,检测所有受试者血清TNF-α、CEA、CA242的含量,采用单因素方差分析比较A、B、C组受试者血清TNF-α、CEA、CA242含量的差异;检测A组患者术前1 d、术后5 d、术后10 d、术后1个月血清TNF-α、CEA、CA242的含量,采用重复测量资料的方差分析比较A组患者手术前后各时间点血清TNF-α、CEA、CA242含量的差异。结果 A组患者血清TNF-α、CEA、CA242的含量明显高于B、C组,差异有统计学意义（P〈0.05）;A组患者手术治疗后血清TNF-α、CEA、CA242含量较手术治疗前明显下降,血清TNF-α、CEA、CA242含量在各时间点差异有统计学意义（P〈0.05）。结论 多数RC患者血清TNF-α、CEA、CA242含量明显升高,血清TNF-α、CEA、CA242的联合检测有助于RC的诊断、疗效判定及病情监测。

Objective To dynamically observe the serum levels of tumor necrosis factor-α（ TNF-α）,carcinoembryonic antigen（ CEA） and carbohydrate antigen 242（ CA242） before and after the surgery for rectal cancer（ RC）. To explore the clinical value of combined detection of TNF-α,CEA and CA242 for the diagnosis,valuing curative effect and illness monitoring for RC. Methods From January,2014 to June,2014,60 cases of rectal diseases（ including 30 cases of RC in Group A and 30 cases of benign rectal disease in group B） and 30 cases of healthy adults（ Group C） were enrolled into this study. The serum levels of TNF-α,CEA and CA242 were measured and compared among the three groups by using one-way analysis of variance. In group A,the serum levels of TNF-α,CEA and CA242 were measured one day before the surgery,five days after the surgery,ten days after the surgery and one month after the surgery were tested and analyzed by repeated measures analysis of variance. Results The serum levels of TNF-α,CEA and CA242 in group A were significantly higher than those in group B and group C,and there was significant difference between group A and group B or C（ P〈0. 05）. In addition,the serum levels of TNF-α,CEA and CA242 in group A were decreased after the surgical treatment and there was significant difference at different time points（ P〈0. 05）. Conclusion The serum levels of TNF-α,CEA and CA242 in most patients of RC are significantly elevated and the combined detection of serum TNF-α,CEA and CA242 contributes to the diagnosis,valuing curative effect and illness monitoring for RC.