多层螺旋CT平扫联合血清肿瘤标志物检测对结直肠癌的诊断价值

Diagnostic value of multi-slice spiral CT plain scan enhanced scanning combined with serum tumor markers for colorectal cancer

目的:探讨多层螺旋CT(multi-slice spiral CT,MSCT)平扫联合血清肿瘤标志物(tumor markers,TM)检测对结直肠癌(colorectal cancer,CRC)的诊断价值。方法:选取2017年1月至2022年1月在皖西卫生职业学院附属医院就诊的100例CRC患者(CRC组)与70例良性结直肠病变患者(对照组),均行血清癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原199(carbohydrate antigen 199,CA199)检测,并完成MSCT平扫。比较2组CEA、CA199水平差异,分析CEA、CA199水平与临床病理参数的关系,并应用受试者操作特征(receiver operating characteristic,ROC)曲线评价CEA、CA199及MSCT对CRC的诊断价值。结果:CRC组血清CEA、CA199水平分别为(36.36±9.78)ng/mL、(134.19±35.72)U/mL,均显著高于对照组的(15.35±4.12)ng/mL、(49.72±14.69)U/mL,差异均有统计学意义(均P<0.05)。临床分期为III+IV期的患者血清CEA、CA199水平均显著高于Ⅰ+Ⅱ期患者(均P<0.05)。ROC曲线分析显示:CEA+CA199联合检测的曲线下面积(0.859)大于单一TM检测(P<0.05),联合检测特异度明显提高;且TM联合CT的曲线下面积进一步增大(0.911),其敏感度为75.0%,特异度为94.3%。结论:MSCT平扫联合血清CEA、CA199检测可提高对CRC的诊断效能,有助于减少误诊和漏诊。

Objective:To investigate the diagnostic value of multi-slice spiral CT(MSCT)plain scan combined with serum tumor markers(TM)detection in colorectal cancer(CRC).Methods:A total of 100 patients with CRC(CRC group)and 70 patients with benign colorectal lesions(control group)who were treated in Affiliated Hospital of Wanxi Health Vocational College from January 2017 to January 2022 were selected.Serum carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)were performed,and MSCT plain scan were completed.The differences in the levels of CEA and CA199 between the 2 groups were compared,and the relationship between the levels of CEA and CA199 and clinicopathological parameters was analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of CEA,CA199 and the diagnostic value of MSCT in CRC.Results:The serum CEA and CA199 levels in the CRC group were(36.36±9.78)ng/mL and(134.19±35.72)U/mL,respectively,which were significantly higher than(15.35±4.12)ng/mL and(49.72±14.69)U/mL in the control group,and the difference was significant(all P<0.05).The levels of serum CEA and CA199 in patients with clinical stage III+IV were significantly higher than those in patients with stage I+II(all P<0.05).ROC curve analysis showed that the area under the curve(0.859)of CEA+CA199 combined detection was larger than that of single TM detection(P<0.05),and the specificity of combined detection was significantly improved.The area under the curve of TM combined with CT was further increased(0.911),and the sensitivity was 75.0%,and the specificity was 94.3%.Conclusion:MSCT plain scan combined with serum CEA and CA199 detection can improve the diagnostic efficiency of CRC,and help to reduce misdiagnosis and missed diagnosis.