血清CEA、CA199和D-二聚体联合检测对结直肠癌转移的临床意义

Clinical Significance of Combined Detection of Serum CEA,CA199 and D-dimer in Colorectal Cancer Metastasis

目的分析癌胚抗原(CEA)、糖类抗原199(CA199)和D-二聚体(D-D)联合检测对结直肠癌转移的临床意义。方法选取2018年11月至2020年9月贵州医科大学附属肿瘤医院治疗的83例结直肠癌患者作为研究对象,根据是否发生转移分为转移组(41例)和非转移组(42例)。比较两组患者的CEA、CA199和D-D表达水平变化,采用Logistic回归分析CEA、CA199及D-D表达水平对结直肠癌转移的诊断价值,并采用受试者工作特征曲线(ROC曲线)分析CEA、CA199及D-D表达水平对结直肠癌转移的预测效能。结果单因素分析结果显示,转移组年龄≥60岁、伴有饮酒史患者比例及CEA、CA199和D-D表达水平均高于非转移组[56.1%(23/41)比33.3%(14/42)、46.3%(19/41)比23.8%(10/42)、(6.1±2.2)ng/L比(3.3±1.1)ng/L、(76±29)kU/L比(37±21)kU/L、(2.5±0.7)mg/L比(1.4±0.6)mg/L](P<0.05或P<0.01);两组患者的性别、癌症类型、居住地、体质量指数、吸烟史比较差异无统计学意义(P>0.05)。Logistic回归分析结果显示,年龄≥60岁、有饮酒史及血清CEA、CA199和D-D表达水平升高为结直肠癌转移的独立危险因素(P<0.05或P<0.01);ROC曲线分析显示,血清CEA、CA199以及D-D的AUC分别为0.887、0.879以及0.899,而联合预测概率的AUC为0.995。结论结直肠癌转移的发生与血清CEA、CA199及D-D表达水平密切相关,血清CEA、CA199和D-D联合检测可提高诊断结直肠癌转移的预测价值。

Objective To analyze the clinical significance of combined detection of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and D-dimer(D-D)on colorectal cancer metastasis.Methods A total of 83 patients with colorectal cancer treated in the Affiliated Cancer Hospital of Guizhou Medical University from Nov.2018 to Sep.2020 were included,and divided into a metastasis group(41 cases)and a non-metastasis group(42 cases)according to whether there was metastasis.The expression levels of CEA,CA199 and D-D were compared between the two groups.Logistic regression was used to analyze the diagnostic value of CEA,CA199 and D-D expression levels for colorectal cancer metastasis.The receiver operating characteristic curve(ROC curve)was used to analyze colorectal cancer.Predictive efficacy of CEA,CA199 and D-D expression levels for colorectal cancer metastasis in metastatic patients.Results The results of univariate analysis showed that the proportions of patients aged≥60 years,with drinking history and the expression levels of CEA,CA199 and D-D in the metastasis group were higher than those in the non-metastasis group[56.1%(23/41)vs 33.3%(14/42),46.3%(19/41)vs 23.8%(10/42),(6.1±2.2)ng/L vs(3.3±1.1)ng/L,(76±29)kU/L vs(37±21)kU/L,(2.5±0.7)mg/L vs(1.4±0.6)mg/L](P<0.05 or P<0.01);there was no significant difference in gender,cancer type,residence,body mass index,and smoking history between the two groups(P>0.05).Logistic regression analysis showed that age≥60 years old,drinking history and elevated serum CEA,CA199 and D-D expression levels were independent risk factors for colorectal cancer metastasis(P<0.05 or P<0.01);ROC curve analysis showed that the AUC of serum CEA,CA199 and D-D were 0.887,0.879,and 0.899,respectively,while the AUC of the joint prediction probability was 0.995.Conclusion The occurrence of colorectal cancer metastasis is closely related to the expression levels of serum CEA,CA199 and D-D.The combined detection of serum CEA,CA199 and D-D can improve the predictive value of colorectal cancer metastasis.