CEA、CA125、CA199对消化道神经内分泌肿瘤的诊断价值研究

Study on diagnostic value of CEA,CA125 and CA199 in gastrointestinal neuroendocrine neoplasms

目的 探讨癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)对消化道神经内分泌肿瘤(GI-NENs)的诊断价值。方法 以十堰市人民医院2010年3月至2021年5月收治的45例GI-NENs患者为试验组,以同期在该院体检的45例健康者为对照组。分析两组CEA、CA125、CA199水平的差异,构建Logistic回归分析模型,绘制受试者工作特征(ROC)曲线分析CEA、CA125、CA199单项及联合检测对GI-NENs的诊断效能。结果 试验组中CEA、CA125水平明显高于对照组,差异均有统计学意义(P<0.05)。两组CEA、CA125、CA199升高比例比较,差异均有统计学意义(P<0.05)。在不同病理分级的GI-NENs患者中,CEA水平升高比例差异有统计学意义(P<0.05),而CA125、CA199水平升高比例差异无统计学意义(P>0.05)。在是否存在淋巴结转移的患者中,CEA、CA125、CA199水平升高比例差异均无统计学意义(P>0.05)。CEA、CA125水平升高是GI-NENs发生的危险因素(P<0.05)。CEA、CA125单独检测诊断GI-NENs的AUC分别为0.672(95%CI:0.561~0.784)、0.674(95%CI:0.563~0.784),均低于CEA、CA125联合检测诊断GI-NENs的AUC[0.735(95%CI:0.632~0.838)],差异有统计学意义(P<0.05)。结论 CEA、CA125水平在GI-NENs患者中明显升高,且CEA、CA125水平升高是GI-NENs发生的危险因素,联合检测CEA、CA125水平对GI-NENs有一定的诊断价值。

Objective To investigate the diagnostic value of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and carbohydrate antigen 199(CA199)in gastrointestinal neuroendocrine neoplasms(GI-NENs).Methods Forty-five patients with GI-NENs admitted and treated in Shiyan Municipal People′s Hospital from March 2010 to May 2021 were taken as the experimental group and 45 healthy subjects undergoing physical examination in the same period were taken as the control group.The differences of CEA,CA125 and CA199 levels between the two groups were analyzed,the Logistic regression analysis model was constructed,and the receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of CEA,CA125 and CA199 single item detection and their combined detection for diagnosing GI-NENs.Results The levels of CEA and CA125 in the experimental group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).The proportion of CEA,CA125 and CA199 increase had statistical difference between the two groups(P<0.05).The difference in the proportion of CEA level increase among the patients with different pathological grades of GI-NENs had statistical significance(P<0.05);while the proportion of CA125 and CA199 levels increase had no statistical significance(P>0.05).There was no statistically significant difference in the proportion of CEA,CA125,and CA199 levels increase between the patients with or without lymph node metastasis(P>0.05).The increase of CEA and CA125 levels was the risk factor for the GI-NENs occurrence(P<0.05).The areas under the ROC curves(AUC)of CEA and CA125 detection alone for diagnosing GI-NENs were 0.672(95%CI:0.561-0.784)and 0.674(95%CI:0.563-0.784)respectively,which were lower than 0.735(95%CI:0.632-0.838)of CEA and CA125 combined detection for diagnosing GI-NENs,and the differences were statistically significant(P<0.05).Conclusion The CEA and CA125 levels in the patients with GI-NENs are significantly increased,moreover the increase of CEA and CA125 levels is the risk factor for GI-NENs occurrence.The combined detection of CEA and CA125 levels has certain diagnostic value for GI-NENs.