血清氨基酸与CEA及CA19-9对结直肠良恶性占位性病变的诊断价值

Diagnostic Value of Serum Amino Acid,CEA and CA19-9 in Benign and Malignant Colorectal Space-occupying Lesions

【目的】探讨血清氨基酸与癌胚抗原(CEA)和糖类抗原(CA19-9)对结直肠良恶性占位性病变的鉴别诊断效果。【方法】于本院接受治疗的94例结直肠占位性病变患者均接受结肠镜取活组织做病理检查,根据检查结果分为两组,对照组为良性病灶患者,共63例,观察组为恶性病灶者,共31例,比较两组患者的基本临床资料以及血清氨基酸、CEA和CA19-9水平,对比较有统计学意义的指标行多因素logistic分析,探究结直肠恶性占位性病变的危险因素。【结果】观察组瓜氨酸、乙醇胺、CEA以及CA19-9水平高于对照组,缬氨酸、5-羟色胺、亮氨酸水平低于对照组,且差异均有显著性(P<0.05);多因素logistic分析显示,瓜氨酸升高、乙醇胺升高、缬氨酸降低、5-羟色胺降低、亮氨酸降低、CEA升高、CA19-9升高是结直肠恶性占位性病变的危险因素。【结论】血清氨基酸与CEA、CA19-9对鉴别诊断结直肠良恶性占位性病变具有重要意义,瓜氨酸、乙醇胺、血清CEA、CA19-9水平升高,缬氨酸、5-羟色胺、亮氨酸水平降低是结直肠恶性占位性病变的危险因素。

【Objective】To explore the application of serum amino acid,CEA and CA19-9 on the differential diagnosis of benign and malignant colorectal space-occupying lesions.【Methods】A total of 94 patients with colorectal space-occupying lesions treated in our hospital were selected.According to the examination results,patients were divided into two groups:the control group with benign lesions(n=63)and the observation group with malignant lesions(n=31).The basic clinical data,serum amino acid,CEA and CA19-9 levels were compared between the two groups.Statistically significant indicators were evaluated by multi-factor logistic analysis to explore the risk factors of malignant colorectal space-occupying lesions.【Results】The levels of citrulline,ethanolamine,serum carcinoembryonic antigen(CEA)and carbohydrate antigen(CA19-9)in the observation group were higher than those in the control group,while the levels of valine,serotonin and leucine were lower than the control group,and the differences were statistically significant(P<0.05).Multivariate logistic analysis showed that elevated citrulline,elevated ethanolamine,lowered valine,lowered serotonin,lowered leucine,elevated CEA,and elevated CA19-9 were the risk factors for colorectal malignant mass lesions.【Conclusion】Serum amino acids and CEA/CA19-9 are of great significance for the differential diagnosis of colorectal benign and malignant space-occupying lesions.The increased levels of citrulline,ethanolamine,CEA and CA19-9 and the decreased levels of valine,serotonin and leucine in patients may have the risk for colorectal malignant space-occupying lesions.