血清ESM-1、TuM2-PK联合结肠镜检查诊断早期结直肠癌的临床价值

Clinical value of serum ESM-1 and TuM2-PK combined with colonoscopy in the diagnosis of early colorectal cancer

目的:探讨血清内皮细胞特异性分子-1(ESM-1)、肿瘤M2型丙酮酸激酶(TuM2-PK)联合结肠镜检查诊断早期结直肠癌的临床价值。方法:纳入120例疑似结直肠癌患者,根据病理检查结果分为恶性组(n=52)、良性组(n=68),两组均行血清ESM-1、TuM2-PK检测及结肠镜检查,分析ESM-1、TuM2-PK单独及联合诊断结直肠癌的诊断效能。结果:恶性组血清ESM-1、TuM2-PK水平均高于良性组(P<0.05),结肠镜检查阳性率高于良性组(P<0.05);结肠镜阳性患者血清ESM-1、TuM2-PK水平均高于阴性组(P<0.05);ESM-1、TuM2-PK单独及联合诊断结直肠癌的敏感度与特异度分别为72.12%与69.12%、67.31%与63.24%、78.85%与66.18%,对应的曲线下面积(AUC)分别为0.79、0.75、0.83;以病理诊断为“金标准”,血清ESM-1、TuM2-PK联合结肠镜诊断结直肠癌的敏感度、特异度、准确度及Kappa值分别为98.08%、80.88%、88.33%、0.77。结论:血清ESM-1、TuM2-PK联合结肠镜对早期结直肠癌有较高的诊断效能,联合检测与病理检查有较好的一致性。

Objective:To explore the clinical value of serum endothelial cell specific molecule-1(ESM-1)and tumor M2-pyruvate kinase(TuM2-PK)combined with colonoscopy in the diagnosis of early colorectal cancer.Methods:A total of 120 patients with suspected colorectal cancer were selected and divided into malignant group(n=52)and benign group(n=68)according to the pathological examination results.Serum ESM-1,TuM 2-PK test and colonoscopy were performed to analyze the diagnostic efficacy of ESM-1,TuM 2-PK alone and combined for the diagnosis of colorectal cancer.Results:The levels of serum ESM-1 and TuM2-PK in malignant group were higher than those in benign group(P<0.05),and the positive rate of colonoscopy was higher than benign group(P<0.05).Serum levels of ESM-1 and TuM2-PK in colonoscopy-positive patients were higher than those in negative group(P<0.05).The sensitivities/specificities of ESM-1 and TuM2-PK alone and in combination in the diagnosis of colorectal cancer were 72.12%/69.12%,67.31%/63.24%and 78.85%/66.18%,and the corresponding areas under the curves(AUC)were 0.79,0.75 and 0.83 respectively.Taking pathological diagnosis as the“gold standard”,the sensitivity,specificity,accuracy and Kappa value of serum ESM-1 and TuM2-PK combined with colonoscopy in the diagnosis of colorectal cancer were 98.08%,80.88%,88.33%and 0.77,respectively.Conclusion:Serum ESM-1,TuM2-PK combined with colonoscopy has high diagnostic efficiency on early colorectal cancer,and the combined detection has good consistency with pathological examination.