血清CRP与肿瘤标志物检测在消化道恶性肿瘤诊断中的应用价值

Value of serum CRP and tumor marker detection in the diagnosis of gastrointestinal malignant tumors

目的探讨在消化道恶性肿瘤患者的临床诊断中运用血清C-反应蛋白(CRP)与肿瘤标志物检测方式进行鉴别诊断的临床价值。方法筛选出2017年2月至2019年6月濮阳市人民医院收治的消化道恶性肿瘤患者108例,将其作为恶性组,另选取消化道良性病变患者108例作为良性组,选取同期108例健康体检者作为参照组。给予全部入选人员血清CRP水平检测及肿瘤标志物检测处理。记录并比较入院时各组的血清CRP水平以及甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原(CA)125、CA19-9水平。观察入院时、诊治后、复发时等三个时间节点恶性组的血清CRP水平以及AFP、CEA、CA125、CA19-9水平。比较入院时、诊治后良性组与恶性组血清CRP水平及肿瘤标志物水平对消化道病变的阳性检测率。结果入院时,与参照组比较,良性组及恶性组血清CRP水平及肿瘤标志物水平均显著增高,良性组血清CRP水平明显超过恶性组,而恶性组各项肿瘤标志物水平均明显超过良性组(P<0.05)。经相关诊治处理后,与入院初期比较,恶性组血清CRP水平及肿瘤标志物水平显著降低(P<0.05),随访后发现32例复发患者,复发时患者的血清CRP水平及肿瘤标志物水平显著增高(P<0.05)。与诊治前比较,接受治疗后恶性组血清CRP及肿瘤标志物的阳性检测率显著下降(P<0.05)。结论血清CRP对早期良恶性消化道病变的鉴别诊断价值相对较低,在消化道恶性肿瘤的鉴别诊断中,单一血清CRP检测方式和肿瘤标志物检测方式与血清CRP、肿瘤标志物联合检测方式的阳性检测率比较差异未见统计学意义。不过,术后肿瘤复发时患者的血清CRP水平显著增高,故而可以将血清CRP视为动态观察指标,以有效防控肿瘤复发。

Objective To investigate the clinical value of serum CRP and tumor markers in the diagnosis of malignant tumors of the digestive tract.Methods One hundred and eight patients with malignant tumors of the digestive tract who were treated in Puyang People’s Hospital from February 2017 to June 2019 were selected as the malignant group,108 patients with benign gastrointestinal lesions were treated as benign group,and 108 healthy medical examinations were selected as a reference group.All the selected persons were given serum CRP level detection and tumor marker detection treatment.The serum CRP levels of each group at the time of admission and the levels of tumor markers such as alphafetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125,CA19-9 were recorded and compared.The serum CRP levels and the levels of tumor markers such as AFP,CEA,CA125,CA19-9 were observed in the malignant group at the time of admission,diagnosis and relapse.The positive detection rate of serum CRP levels and tumor marker levels in the benign and malignant groups on the digestive tract lesions at the time of admission and treatment were compared.Results At admission,the serum CRP levels and tumor marker levels were significantly higher in the benign and malignant groups than those in the reference group.The serum CRP levels in the benign group were significantly higher than those in the malignant group,while the levels of tumor markers in the malignant group were significantly higher than the benign group(P<0.05).After relevant diagnosis and treatment,the serum CRP levels and tumor markers were significantly lower in the malignant group than those in the initial stage of admission(P<0.05).After resection,32 patients with recurrence,serum CRP levels and tumor markers were found.The level was significantly increased(P<0.05).Compared with the diagnosis and treatment,the positive detection rate of serum CRP and tumor markers in the malignant group decreased significantly after treatment(P<0.05).Conclusions Serum CRP is relatively low in the differential diagnosis of early benign and malignant gastrointestinal diseases.In the differential diagnosis of digestive tract malignant tumors,single serum CRP detection method and tumor marker detection method and serum CRP,tumor marker combined detection method is positive.There was no significant difference in the detection rate control.However,the serum CRP level of the patients will be significantly increased after the tumor recurrence,so serum CRP can be regarded as a dynamic observation index to prevent and effectively prevent tumor recurrence.