Array-ELISA检测六项肿瘤标志物诊断结直肠癌的临床价值分析

Clinical value of Array-ELISA in detecting six tumor markers in diagnosis of colorectal cancer

目的:探讨微阵列酶联免疫法(Array-ELISA)检测六项肿瘤标志物诊断结直肠癌(CRC)的临床价值。方法:选择49例CRC患者作为CRC组,选择19例同期进行结直肠手术的良性病变患者作为良性组,另取同期71例健康体检者作为对照组。采集3组患者的静脉血,通过Array-ELISA技术进行六项肿瘤标志物(AFP、CEA、PSA、CA125、CA153及CA199)检测。比较3组血清六项肿瘤标志物检测结果、CRC组ROC AUC结果、以及CRC组PRE与6项肿瘤标志物的相关参数。结果:(1)CRC组血清CEA、AFP、CA199及CA125水平均高于良性组与对照组(P<0.05)。3组PSA与CA153水平比较,差异无统计学意义(P>0.05)。(2)单项检测中CEA(AUC=0.916,P=0.001)具有最高的诊断价值,Logistic回归模型建立的PRE面积为0.932,均高于单项指标检测。(3)本组CRC患者中的CEA特异度、灵敏度与准确率在单项中最高;联合检测中Logistic回归预测变量PRE的特异度、灵敏度与准确率高于CEA(P<0.05)。结论:Array-ELISA对CRC患者六项肿瘤标志物均有理想的检测效果,但单项肿瘤标志物的特异度、灵敏度具有一定的局限性,六项指标联合检测可以有效提高CRC的检出率。

Objective：To evaluate the clinical value of Array-ELISA in the detection of six tumor markers in colorectal cancer （CRC）.Methods：49 cases of CRC patients as CRC group,19 cases of benign lesions were selected for colorectal surgery as the benign group,71 healthy subjects another same medical examination as the control group.The venous blood of three groups of patients was collected,and six tumor markers （AFP,CEA,PSA,CA125,CA153 and CA199） were detected by Array-ELISA technique.The serum markers of six tumor markers,the results of CRC,ROC and AUC in the three groups were observed and compared,and the parameters related to PRE and 6 tumor markers in group CRC were observed.Results：The serum CEA,CRC,CA199 and CA125 levels in CRC group were higher than those of benign group and control group （P〈0.05）.There was no significant difference between the three groups of PSA and CA153 （P〈0.05）.The single detection of CEA （AUC = 0.916,P = 0.001） had the highest diagnostic value of the Logistic regression model to establish the area for the PRE 0.932,were higher than the single index detection.The patients with CRC CEA in specificity,sensitivity and accuracy was the highest in the individual,combined detection in Logistic regression prediction variable PRE specificity,sensitivity and accuracy was higher than that of CEA （P〈0.05）.Conclusion：Array-ELISA marker detection effect has the ideal of CRC patients with six tumor,but single tumor marker specificity and sensitivity has certain limitations,combined detection of six indexes can effectively improve the detection rate of CRC.