血清CA724、CEA及多层螺旋CT检查对结直肠癌及转移的诊断价值

Diagnostic value of serum CA724,CEA and multi-slice spiral CT on colorectal cancer and metastasis

目的探究血清糖类抗原724(CA724)、癌胚抗原(CEA)及多层螺旋CT(MSCT)检查对结直肠癌及转移的诊断价值。方法回顾性分析2020年4月至2022年2月遂宁市中心医院收治的109例疑似结直肠癌患者的临床资料,患者均采集血液样本,检测血清CA724、CEA水平,且行MSCT检查、病理检查。以病理检查结果作为金标准,比较恶性组(n=54)和良性组(n=55)患者的血清CA724、CEA水平,记录MSCT检查诊断结直肠癌的诊断准确率和阳/阴性预测值,使用受试者工作特征(ROC)曲线分析血清CA724、CEA、MSCT检查对结直肠癌定性诊断的诊断效能。将恶性组患者根据治疗前是否发生转移进行分组,比较转移组(n=24)和非转移组(n=30)患者的血清CA724、CEA水平,记录MSCT检查对结直肠癌治疗前转移的诊断准确率和阳/阴性预测值,使用ROC曲线分析血清CA724、CEA、MSCT检查对结直肠癌治疗前转移的诊断效能。结果恶性组患者血清CA724、CEA分别为(10.02±4.10)U/mL、(21.36±8.20)ng/mL,均高于良性组患者[(3.83±1.75)U/mL、(6.10±2.15)ng/mL],差异均有统计学意义(P<0.05)。MSCT检查对结直肠癌的诊断准确率为86.24%,阳性预测值为84.21%,阴性预测值为88.46%;ROC曲线结果显示,CEA、CA724、MSCT检查对结直肠癌的诊断效能依次降低(AUC=0.973、0.939、0.863)。转移组患者血清CA724、CEA分别为(11.92±4.37)U/mL、(24.35±7.25)ng/mL,均高于非转移组患者[(8.51±3.20)U/mL、(18.97±8.24)ng/mL],差异均有统计学意义(P<0.05);MSCT检查对结直肠癌转移的诊断准确率为59.26%,阳性预测值为53.57%,阴性预测值为65.38%;ROC曲线结果显示,CA724、CEA、MSCT检查对结直肠癌治疗前转移的诊断效能依次降低(AUC=0.725、0.700、0.596)。结论血清CA724、CEA及MSCT检查可用于诊断结直肠癌及其治疗前转移,且其中血清指标的效能更高。

Objective To explore the diagnostic value of serum carbohydrate antigen 724(CA724),carcinoembryonic antigen(CEA)and multi-slice spiral CT(MSCT)examination in the diagnosis of colorectal cancer and metastasis.Methods The clinical data of 109 patients with suspected colorectal cancer who were treated in the Suining Central Hospital from April 2020 to February 2022 were retrospectively analyzed.Blood samples were collected from the patients to detect the levels of serum CA724 and CEA,and MSCT examination and pathological examination were performed.Taking the pathological examination results as the gold standard,serum CA724 and CEA levels were compared between the malignant group(n=54)and the benign group(n=55),and the diagnostic accuracy rate and positive/negative predictive value of MSCT examination in diagnosing colorectal cancer were recorded,and receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of serum CA724,CEA,and MSCT examination in the qualitative diagnosis of colorectal cancer.The patients in the malignant group were grouped according to whether there was metastasis before treatment,and serum CA724 and CEA levels of the patients in the metastatic group(n=24)and the non-metastatic group(n=30)were compared,and the diagnostic accuracy rate and positive/negative predictive value of MSCT examination on metastasis before colorectal cancer treatment were recorded.ROC curve was applied to analyze the diagnostic efficiency of serum CA724,CEA,and MSCT examination on metastasis before colorectal cancer treatment.Results The levels of serum CA724 and CEA in the malignant group were(10.02±4.10)U/mL and(21.36±8.20)ng/mL,whch were higher than those in in the benign group[(3.83±1.75)U/mL and(6.10±2.15)ng/mL],the differences were statistically significant(P<0.05).The diagnostic accuracy rate,positive predictive value and negative predictive value of MSCT examination on colorectal cancer were 86.24%,84.21%and 88.46%.ROC curve results showed that the diagnostic efficiencies of CEA,CA724 and MSCT examination on colorectal cancer decreased in turn(AUC=0.973,0.939,0.863),but the sensitivities were 90.74%,98.15%,88.89%and 100.00%respectively.The levels of serum CA724 and CEA in the metastatic group were(11.92±4.37)U/mL and(24.35±7.25)ng/mL,which were higher than those in the non-metastatic group[(8.51±3.20)U/mL and(18.97±8.24)ng/mL],the differences were statistically significant(P<0.05).The diagnostic accuracy rate of MSCT examination on colorectal cancer metastasis was 59.26%,with the positive predictive value of 53.57%and the negative predictive value of 65.38%.ROC curve revealed that the diagnostic efficiencies of CA724,CEA and MSCT examination on metastasis before colorectal cancer treatment reduced sequentially(AUC=0.725,0.700,0.596).Conclusion Serum CA724,CEA and MSCT examination can be used to diagnose colorectal cancer and its metastasis before treatment,and the efficiency of serum indicators is higher.