摘要
目的探讨术前血清胱抑素C(Cys C)、癌胚抗原(CEA)及抗原199(CA199)在结直肠癌中的表达特点及诊断价值。方法选取2018年1月至2020年1月徐州医科大学附属医院经手术后病理学证实的结直肠癌病人215例(结直肠癌组)、结直肠良性疾病病人110例(对照组),检测两组血清Cys C、CEA、CA199水平,将结直肠癌病人根据TNM分期、是否发生淋巴结转移进行亚组分析;采用logistic回归分析结直肠癌的危险因素;并用受试者工作特征(ROC)曲线评价Cys C、CEA、CA199及3种指标联合检测诊断结直肠癌的效能。结果结直肠癌组病人的血清Cys C[0.85(0.77,1.16)mg/L]、CEA[2.59(1.67,5.06)µg/L]、CA199[11.58(8.20,37.90)U/mL]水平显著高于对照组[0.73(0.68,0.92)mg/L、1.76(1.11,2.44)µg/L、9.03(5.90,13.21)U/mL,均P<0.05];TNM分期Ⅲ期+Ⅳ期、发生淋巴结转移的结直肠癌病人的血清Cys C、CEA、CA199水平均显著高于TNM分期Ⅰ期+Ⅱ期、未发生淋巴结转移的结直肠癌病人(P<0.05);年龄、Cys C、CEA、CA 199均为结直肠癌发生的危险因素;结直肠癌诊断的ROC曲线下面积,三种指标联合检测以及Cys C、CEA、CA199单独检测的结果分别为0.738、0.702、0.690、0.662,3种指标联合检测对结直肠癌的诊断效能较好。结论Cys C、CEA、CA199在结直肠癌病人血清中显著升高,三者联合应用对于结直肠癌的术前诊断有重要价值。
Objective To explore the expressive feature and diagnostic value of serum cystatin C(Cys C),carcinoembryonic antigen(CEA)and antigen 199(CA199)in patients with colorectal cancer.Methods A total of 215 patients with colorectal cancer(colorectal cancer group)and 110 benign colorectal diseases subjects(control group),who were pathologically confirmed after undergoing surgery in The Affiliated Hospital of Xuzhou Medical University from January 2018 to January 2020,were enrolled in this study.Serum levels of Cys C,CEA and CA199 were measured in both groups.Patients with colorectal cancer were subdivided according to TNM staging and lymph node metastasis condition.Logistic regression analysis was made of the risk factors for colorectal cancer.The receiver operating characteristic(ROC)curve was also used to evaluate the efficacy of Cys C,CEA,CA199 and these three combined indicators in the diagnosis of colorectal cancer.Results Levels of serum Cys C[0.85(0.77,1.16)mg/L],CEA[2.59(1.67,5.06)µg/L]and CA199[11.58(8.20,37.90)U/mL]in patients with colorectal cancer were significantly higher than those in the control group[0.73(0.68,0.92)mg/L,1.76(1.11,2.44)µg/L,9.03(5.90,13.21)U/mL;all P<0.05].The levels of the above indicators in colorectal cancer patients with lymphatic metastasis inⅢandⅣstages were significantly higher than those in I,Ⅱphase of TNM staging,and those without lymph node metastasis(P<0.05).Age,Cys C,CEA,CA199 were all risk factors for colorectal cancer.The area under the ROC curve for the diagnosis of colorectal cancer,the combined detection of the three indicators and the separate detection of Cys C,CEA,and CA199 were 0.738,0.702,0.690,and 0.662,respectively.The combined detection of the three indicators had a better diagnostic effect on colorectal cancer.Conclusions Cys C,CEA,and CA199 are significantly increased in the serum of patients with colorectal cancer.The combined application of the three is of great value in the pre-operative diagnosis of colorectal cancer.
作者
张程程
费素娟
ZHANG Chengcheng;FEI Sujuan(Department of Gastroenterology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)
出处
《安徽医药》
CAS
2022年第10期2038-2041,共4页
Anhui Medical and Pharmaceutical Journal
关键词
结直肠肿瘤
胱抑素C
癌胚抗原
抗原199
早期诊断
Colorectal neoplasms
Serum cystatin C
Carcino-embryonic antigen
Antigen 199
Early diagnosis
