血小板活化因子、癌胚抗原、糖类抗原724在结直肠癌中的表达及与临床病理特 征的关系

Expression of PAF,CEA and CA-724 in colorectal cancer and their relationship with clinicopathology features

目的:探讨血小板活化因子(PAF)、癌胚抗原(CEA)、糖类抗原724(CA-724)在结直肠癌(CRC)患者术前血清中的阳性表达率及与临床病理特征的关系、发病的独立危险因素。方法:选取2019年12月至2021年10月于包头医学院第一附属医院就诊的CRC患者75例为CRC组,另选取同时期在本院体检的健康志愿者75例为对照组。采用酶联免疫吸附(ELISA)法分别检测CRC患者术前及对照组的晨空腹外周静脉血PAF含量;回顾性分析上述入组患者术前血清CEA、CA-724含量,进行统计分析。结果:(1)CRC组PAF、CEA、CA-724单独检测和联合检测的阳性率分别为25.33%、42.67%、30.67%、74.67%,均高于对照组,且联合检测的阳性率均高于单独检测指标的阳性率,组间差异均具有统计学意义(P<0.05);(2)单因素方差分析结果显示,血清CEA表达水平的影响因素为患者的淋巴结转移(P<0.05);血清CA-724表达水平的影响因素为患者的年龄(P<0.05);(3)二元Logistic回归分析结果显示,PAF表达在临床病理特征之间的差异无统计学意义(P>0.05),淋巴结转移是CEA的独立危险因素(P<0.05),年龄是CA-724的独立危险因素(P<0.05);(4)根据Youden指数,以PAF>98.72 ng/mL为诊断CRC的依据时,灵敏度为90.70%,特异性为76.70%(P<0.05)。结论:PAF、CEA、CA-724联合检测可以提高CRC的检出率,有望成为CRC的早期筛查与诊断的血清标志物。

Objective:To investigate the positive expression rate of platelet activating factor(PAF),carcinoembryonic antigen(CEA)and carbohydrate antigen 724(CA-724)in preoperative serum of patients with colorectal cancer(CRC)and their relationship with clinicopathological characteristics,pathogenesis independent risk factors.Methods:A total of 75 CRC patients who visited the First Affiliated Hospital of Baotou Medical College from December 2019 to October 2021 were selected as the CRC group,and 75 healthy volunteers who received physical examination in our hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of PAF in the morning fasting peripheral venous blood of CRC patients and the control group respectively.The preoperative serum CEA and CA-724 contents of the above-mentioned patients were retrospectively analyzed,and statistical analysis was performed.Results:(1)The positive rates of PAF,CEA,CA-724 detection alone and combined detection in the CRC group were 25.33%,42.67%,30.67%,and 74.67%,respectively,which were higher than those in the control group,and the positive rates of combined detection were higher than those of the single detection index,the difference between the groups was statistically significant(P<0.05);(2)The results of one-way analysis of variance showed that the influence factor of serum CEA expression level was the patient's lymph node metastasis(P<0.05);the influence factor of serum CA-724 expression level was the patient's age(P<0.05);(36)Binary Logistic regression analysis showed that there was no significant difference in PAF expression between clinicopathological features(P>0.05),lymph node metastasis was an independent risk factor for CEA(P<0.05),and age was an independent risk factor for CA-724 factor(P<0.05);(4)According to Youden's index,When PAF is>98.72 ng/mL as the basis for diagnosing CRC,the sensitivity was 90.70%and the specificity was 76.70%(P<0.05).Conclusion:The combined detection of PAF,CEA and CA-724 can improve the detection rate of CRC,and is expected to become a serum marker for early screening and diagnosis of CRC.