血清巨噬细胞抑制因子-1癌胚抗原及糖类抗原联合检测在老年结直肠癌诊断和预后中的应用

Clinical application of combined detection of serum macrophage inhibitory cytokine-1,carcinoembryonic antigen and carbohydrate antigens for the diagnosis and prognosis of colorectal cancer in the elderly

目的探讨血清巨噬细胞抑制因子-1(MIC-1)、癌胚抗原(CEA)及糖类抗原联合检测在老年结直肠癌诊断和预后中的应用价值。方法回顾性选取172例老年结直肠癌患者作为观察组,另选取同期就诊的结直肠良性病变的老年患者175例作为良性病变组,以及健康体检的老年受试者166例作为对照组。比较三组受试者MIC-1、CEA、糖类抗原199(CA199)、糖类抗原724(CA724)、糖类抗原242(CA242)、糖类抗原125(CA125)、糖类抗原50(CA50)水平,计算诊断效能。并比较观察组不同分期患者上述指标差异,以及不同预后情况上述指标差异。结果观察组患者MIC-1、CEA、CA199、CA242、CA724、CA125和CA50水平均高于良性病变组和对照组,良性病变组上述指标水平高于对照组。MIC-1的灵敏度,阳性预测值和阴性预测值最高,分别为68.6%,72.8%和84.6%。CA199的特异度最高,为91.2%,联合检测大大提高了灵敏度,阳性预测值和阴性预测值,分别为89.0%,79.3%和94.1%。观察组中,Ⅲ、Ⅳ期老年结直肠癌患者MIC-1、CEA、CA199、CA242、CA724、CA125和CA50水平均高于Ⅰ、Ⅱ期患者。老年结直肠癌复发转移组患者MIC-1、CEA、CA199、CA242、CA724、CA125和CA50水平均高于无复发转移组患者。结论多指标联合检测能提高诊断的灵敏度,更有利于老年结直肠癌患者的早期诊断。

Objective To explore the application value of combined detection of serum macrophage inhibitory cytokine-1(MIC-1),carcinoembryonic antigen(CEA)and carbohydrate antigens in the diagnosis and prognosis of elderly patients with colorectal cancer.172 elderly patients with colorectal cancer were selected retrospectively as the observation group,175 elderly patients with benign colorectal lesions were enrolled as the benign lesion group and 166 healthy elderly subjects as the control group.Methods The levels of MIC-1,CEA,carbohydrate antigens of 199(CA199),724(CA724),242(CA242),125(CA125),and 50(CA50)were compared among the three groups,and the diagnostic efficacy was calculated.The difference in the above-mentioned indicators between patients with different stages and prognosis in the observation group were compared.Results Levels of MIC-1,CEA,CA199,CA242,CA724,CA125 and CA50 were higher in the observation group than in the benign lesion group and the control group,and the above indexes were higher in the benign lesion group than in the control group.The sensitivity,positive predictive value and negative predictive value of MIC-1 were the highest in single index test(68.6%,72.8%and 84.6%,respectively).The specificity of CA199 was the highest(91.2%).The combined detections greatly improved sensitivity,positive predictive value and negative predictive value(89.0%,79.3%and 94.1%,respectively).In the observation group,levels of MIC-1,CEA,CA199,CA242,CA724,CA125 and CA50 in the elderly colorectal cancer patients were higher in stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ.The levels of MIC-1,CEA,CA199,CA242,CA724,CA125 and CA50 in elderly patients with recurrence and metastasis of colorectal cancer were higher than those in patients without recurrence and metastasis.Conclusions Combined detection of multiple indicators can improve the sensitivity of diagnosis,and is more conducive to the early diagnosis of elderly patients with colorectal cancer.