联合检测结直肠癌患者血浆 D- 二聚体、CEA 和 CA199 的临床意义

Expression and Clinical Significance of D-Dimmer in Colorectal Cancer

目的探讨联合检测结直肠癌患者血浆D-二聚体、癌胚抗原(carcino-embryonic antigen,CEA)、糖类抗原-199(carbohydrate antigen199,CA199)的临床意义。方法选择2010年3月-2013年3月经病理检查确诊的127例结直肠癌患者作为结直肠癌组,同期选择30例非肿瘤患者作为对照组。检测结直肠癌组患者(术前与术后3个月)和对照组血浆或血清中D-二聚体、CEA、CA199的含量。结果结直肠癌组术前D-二聚体、CEA及CA199水平均高于术后3个月和对照组(P均<0.05)。以病理结果为金标准,D-二聚体、CEA、CA199单独检测时,灵敏度分别为47.25%、55.12%和38.58%,特异度分别为66.67%、63.33%和73.33%。D-二聚体+CEA+CA199联合检测(并联)时,灵敏度升高至75.59%,特异度下降为36.67%,约登指数为12.26%。随着肿瘤分期的增高,CEA水平呈上升趋势,D-二聚体和CA199Ⅱ、Ⅲ、Ⅳ期呈逐渐上升趋势(P<0.05)。结论 D-二聚体、CEA和CA199联合检测可提高结直肠癌诊断的灵敏度,对手术前后病情评估有重要的临床价值。

Objective To investigate the expression level and clinical significance of D-Dimmer in colorectal cancer. Methods 127 cases with colorectal cancer diagnosed by pathological examination between March 2010 and March 2013 were selected as the colorectal cancer group. 30 cases of non tumor patients at the same time were selected as the control group. The expression levels of D-Dimmer, CEA and CA199 were detected in two groups of patients before and 3 months after operation respectively. Results The expression levels of D-Dimmer, CEA and CA199 in colorectal cancer group were significantly higher than those in the control group(P all<0.05) before and the 3rd months after operation. The sensitivity of D-Dimmer, CEA and CA199 were: 47.25%, 55.12% and 38.58%, respectively. The specificity of was 66.67%, 63.33% and 73.33%. The sensitivity and specificity of the combination of D-dimmer, CEA and CA199 were75.59% and 36.67%, and the Youden index was 12.26%. With the increasing of tumor stage, the expression of CEA increased significantly while the expression of D-two and CA199 were significantly increased(P<0.05). Conclusion The combined detection of D-Dimmer, CEA and CA199 can improve the sensitivity of diagnosis of colorectal cancer, and it has important clinical value for the assessment of the disease before and after operation.