CK19、CRP、ALB检测对结直肠癌术后疗效和预后的评估价值

Evaluation value of CK19,CRP and ALB detection in postoperative efficacy and prognosis of colorectal cancer

目的 研究角蛋白19(CK19)、C-反应蛋白(CRP)、白蛋白(Alb)检测对结直肠癌术后疗效、预后的评估价值。方法 选取2018年3月至2020年3月首都医科大学附属北京世纪坛医院收治的112例经临床及手术活检确诊为结直肠癌的患者为研究对象。比较治疗前后和不同疗效、不同预后患者的CK19、CRP、ALB水平,绘制ROC曲线分析CK19、CRP、ALB检测对结直肠癌术后预后的预测价值。结果 治疗后,患者的CK19、CRP、ALB水平较治疗前均下降,差异具有统计学意义(P<0.05)。治疗后CR 57例、PR 33例、SD 13例、PD 9例,总有效率为80.36%。CR+PR组的CK19、CRP水平低于SD+PD组,ALB水平高于SD+PD组,差异具有统计学意义(P<0.05)。随访结束后,生存患者88例(78.57%)。生存组CK19、CRP低于死亡组,ALB高于死亡组,差异具有统计学意义(P<0.05)。ROC曲线分析结果显示,CK19、CRP、ALB三者联合检测预测结直肠癌术后化疗患者预后的下曲线面积(AUC)为0.807、敏感度为0.917、特异度为0.925,均高于单一检测(P<0.05)。结论 CK19、CRP、ALB联合检测能够准确地预测结直肠癌患者术后化疗的疗效及评估患者预后,值得推广使用。

Objective To study the evaluation value of cytokeratin19(CK19),C-reactive protein(CRP)and albumin(ALB)in the postoperative curative effect and prognosis of colorectal cancer. Methods112 patients who were diagnosed with colorectal cancer by clinical and surgical biopsy admitted to Beijing Shijitan Hospital,Capital Medical University from March 2018 to March 2020 were selected as the research objects. The levels of CK19,CRP,and ALB of patients before and after treatment and with different curative effects and different prognosis were compared,and the ROC was drawn to analyze the predictive value of CK19,CRP and ALB detection on the prognosis of postoperative colorectal cancer patients with chemotherapy.Results After treatment,the levels of CK19,CRP,and ALB in patients were decreased compared with those before treatment,and the difference was statistically significant(P<0.05). After treatment,57 cases were CR,33 cases PR,13 cases SD,and 9 cases were PD. The total curative effect was 80.36%. The CK19 and CRP levels in the CR + PR group were significantly lower than those in the SD + PD group,the difference was statistically significant(P<0.05). After the follow-up,88 patients survived(78.57%). CK19 and CRP in the survival group were lower than those in the death group,and the ALB level was higher than that in the death group. The difference was statistically significant(P<0.05). The ROC curve analysis results show that the area of the lower curve(AUC),sensitivity,and specificity of the combined detection of CK19,CRP,and ALB in predicting the prognosis of patients with colorectal cancer after chemotherapy were 0.807,0.917,0.925,respectively,which were higher than those of a single detection(P<0.05). Conclusion The combined detection of CK19,CRP and ALB can accurately predict the efficacy of postoperative chemotherapy and evaluate the prognosis of patients with colorectal cancer,and it is worthy of clinical application.