FH检测在直肠恶性肿瘤早期筛查中的诊断价值

Diagnostic Value of FH Test for Early Screening of Rectal Cancer

目的探讨直肠上皮细胞稳定性FH检测在直肠恶性肿瘤早期筛查中的诊断价值。方法 300例被检者均行直肠上皮细胞稳定性FH、CEA和CA19-9检测。以病理学诊断结果为金标准,辅以电子结肠镜检查,分析上皮细胞稳定性FH、CEA和CA19-9检测对直肠恶性肿瘤筛查的敏感度、特异性、假阴性率(漏诊率)、假阳性率(误诊率)、阴性似然比、阳性似然比、诊断指数、约登指数、粗符合率、阴性预测值、阳性预测值等指标。结果经上皮细胞稳定性FH检测直肠恶性肿瘤患者阳性率高于CEA和CA19-9检测(P=0.000)。40例直肠恶性肿瘤患者中上皮细胞稳定性FH检测出阳性患者38例(95%),CEA检测出阳性患者23例(57.50%),CA19-9检测出阳性患者10例(25.00%)。上皮细胞稳定性FH检测的敏感度、阳性似然比、诊断指数、约登指数、阴性预测值、阳性预测值均高于CEA和CA19-9检测,假阴性率和阴性似然比均低于CEA和CA19-9检测。结论上皮细胞稳定性FH检测在直肠恶性肿瘤筛查中检测结果有较高的敏感度、阳性似然比、诊断指数、约登指数、阴性预测值、阳性预测值,较低的假阴性率和阴性似然比。

Objective To investigate the diagnostic value of rectal epithelial cells stability FH for the early screening of rectal cancer. Methods FH, CEA and CA19-9 were performed in 300 patients. We used pathological diagnostic results as the gold standard and electronic colonoscopy as an assistance to analyze the detection indicators of epithelial cells stability FH, CEA and CA19-9 test for screening rectal malignancy,such as sensitivity(Sen), specificity(Spe), false negative rate(missed diagnosis rate), false positive rate(the misdiagnosis rate), negative likelihood ratio(LR), positive likelihood ratio(LR+), diagnosis index(DI),Youden index, crude coincidence rate(CA), negative predictive value(PV-) and positive predictive value(PV+), etc. Results The positive rate of epithelial cell stability FH test for rectal malignant tumor was higher than those of CEA and CA19-9(P=0.000). Among the 40 cases of rectal malignant tumor, 38 positive cases(95%) were detected by epithelial cell stability FH, 23 positive cases(57.5%) were detected by CEA, 10 positeve cases(25%) were detected by CA19-9. The sensitivity, positive likelihood ratio, diagnostic index,Youden index, negative predictive value and positive predictive value of FH were all higher than those of CEA and CA19-9, while the false negative rate and negative likelihood ratio were lower than CEA and CA19-9.Conclusion There are higher sensitivity, positive likelihood ratio, diagnostic index, Youden index, negative predictive value, positive predictive value, lower false negative rate and negative likelihood ratio of epithelial cells stability FH in rectal cancer screening.