粪便潜血与血浆CEA和CA19-9联合检测在结直肠癌诊断中的应用效果观察

Study of fecal occult blood combined with plasma CEA and CA19-9 in colorectal cancer

目的:观察粪便潜血与血浆癌胚抗原(CEA)和糖类抗原19-9(CA19-9)联合检测在结直肠癌(CRC)诊断中的应用效果。方法:以2017年1月-2022年12月韶关市中医院确诊的200例CRC患者为观察组,以同期参与体检的200名健康人为对照组。利用免疫胶体金法检测所有参与者的粪便潜血,利用化学发光方法检测所有参与者的血浆肿瘤标志物;利用Pearson相关性分析获得粪便潜血、血浆CEA和CA19-9与CRC级别的关系;利用受试者工作曲线(ROC)曲线下面积(AUC)评估粪便潜血联合血浆CEA、CA19-9对在CRC中的诊断效果。结果:观察组CEA、CA19-9水平均高于对照组,差异有统计学意义(P<0.05)。Ⅰ~Ⅱ期CRC患者CEA、CA19-9水平低于Ⅲ~Ⅳ期CRC患者,差异有统计学意义(P<0.05)。Pearson分析显示CEA(r=0.836,P<0.01)、CA19-9(r=0.763,P<0.01)与CRCTNM分期均呈正相关。曲线分析粪便潜血联合CEA、CA19-9诊断的AUC为0.923,与单一指标相比,诊断价值更高。结论:粪便潜血、血浆CEA和CA19-9联合检测用于CRC诊断效果明显好于单一指标,值得在临床应用。

Objective To explore the application of fecal occult blood combined with plasma CEA and CA19-9 in colorectal cancer.Methods 200 colorectal cancer(CRC)patients diagnosed in Shaoguan Hospital of Traditional Chinese Medicine(Shaoguan City)from January 2017 to December 2022 were taken as the observation group,and 200 healthy people participating in physical examination during the same period were taken as the control group.The fecal occult blood of all participants was detected by the method of immunocolloidal gold,and the plasma tumor markers of all participants were detected by chemiluminescence method;The relationship between fecal occult blood,plasma CEA,and CA19-9 and the grade of CRC was obtained by Pearson's correlation analysis;And the receiver operating characteristic(ROC)curve of subjects was used to evaluate the effect of fecal occult blood combined with plasma CEA and CA19-9 on the diagnostic efficacy.Results The levels of CEA and CA19-9 in the observation group were significantly higher than those in the control group,The difference is statistically significant(P<0.05),and the levels of CEA and CA19-9 in patients with stageⅠ-ⅡCRC were significantly lower than those in patients with stageⅢ-IV CRC,The difference is statistically significant(P<0.05).Pearson's analysis showed that the relationship between CEA(r=0.836,P<0.01)and CA19-9(r=0.763,P<0.01)were all positively correlated with CRC TNM stage.The diagnostic efficacy of fecal occult blood combined with CEA and CA19-9 was analyzed using the ROC curve,which showed area under the curve(AUC):0.923,with higher diagnostic value compared with the single index.Conclusions The combination of fecal occult blood,plasma CEA and CA19-9 for the diagnosis of CRC is significantly better than the single indicator,and it is worthwhile to popularize its application in the clinic.