结肠镜联合Hcy、FA及CEA对结肠癌的鉴别诊断价值分析

Colonoscopy Combined with Hcy,FA and CEA in Differential Diagnosis of Colon Cancer

目的:探讨结肠镜联合同型半胱氨酸(Hcy)、叶酸(FA)及癌胚抗原(CEA)对结肠癌的鉴别诊断价值。方法:选取81例行结肠镜检查患者,其中病理活检为结肠癌者53例(A组),活检为结肠息肉者28例(B组),比较2组患者的肠镜检出率等情况。结果:81例患者经肠镜病理检查,确诊53例恶性,占65.4%;A组肠镜检查阳性率、血清Hcy及CEA水平均高于B组(P<0.05),FA水平低于B组(P<0.05);A组患者不同分化程度者的肠镜检查阳性率、血清Hcy、FA及CEA水平比较差异有统计学意义(P<0.05);ROC曲线分析:肠镜联合血清Hcy、FA及CEA水平诊断结肠癌AUC最大(0.958),最佳敏感度和特异度分别为86.7%和93.5%。结论:结肠镜下检查、血清Hcy、FA及CEA水平联合诊断可用于结肠癌诊断及病理状况评估,进而可显著提高结肠癌的诊断价值。

Objective To investigate the value of colonoscopy combined with homocysteine(Hcy),folic acid(FA)and carcinoembryonic antigen(CEA)in differential diagnosis of colon cancer.Methods Total 81patients undergoing colonoscopy were selected,including 53patients with colon cancer diagnosed by pathological biopsy(group A)and 28patients with colon polyp diagnosed by biopsy(group B).The detec-tion rate of colonoscopy in the two groups was compared.Results In 81cases,53cases(65.4%)were confirmed malignant by colonoscopy.The positive rate of colonoscopy,serum levels of Hcy and CEA in group A were higher than those in group B(P<0.05).FA level in group A was lower than that in group B(P<0.05).There were significant differences in the positive rate of colonoscopy,serum levels of Hcy,FA and CEA among different differentiation programs in group A(P<0.05).ROC curve analysis:The AUC of colonoscopy combined with serum levels of Hcy,FA and CEA was the largest(0.958),and the best sensitivity and specificity were 86.7%and 93.5%,respectively.Conclusion The combined diagno-sis of colonoscopy,serum levels of Hcy,FA and CEA can be used for the diagnosis and pathological assess-ment of colon cancer,which can significantly improve the diagnostic value of colon cancer.