炎性介质CRP和SAA与肿瘤标记物CEA、CA19-9和CA72-4术前联合评估结直肠癌  

Clinical value of combined pre-operation determination of inflammatory factors (CRP and SAA) and tumor markers (CEA,CA19-9 and CA72-4) in colorectal cancer

作　　者：汪晓东[1] 高命[2] 吕东昊 张程珑 刘磊[3] 李立[2] 

机构地区：[1]四川大学华西医院肛肠外科,成都610041 [2]四川大学华西医院实验医学科,610041 [3]四川大学华西临床医学院,610041

出　　处：《临床肿瘤学杂志》2009年第4期336-340,共5页Chinese Clinical Oncology

摘　　要：目的:探讨运用炎性介质C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)与肿瘤标记物CEA、CA19-9、CA72-4术前联合评估结直肠肿瘤分期的价值。方法:纳入130例结直肠癌患者,于术前3天测定血清CEA、CA19-9、CA72-4、CRP和SAA的水平,并与术后病理分期进行比较。结果:术前SAA与CRP、CEA有相关性,相关系数分别为r=0.647(P=0.000)和r=0.295(P=0.001);CRP(P=0.021)、SAA(P=0.036)、CA19-9(P=0.017)在不同的TNM分期之间差异有统计学意义;建立CRP、SAA和CA19-9诊断Ⅱ～Ⅳ期结直肠癌的ROC曲线,SAA的曲线下面积(AUC)为0.674(P=0.005),CA19-9的AUC为0.664(P=0.008),CRP的AUC没有统计学意义;以血清SAA值≥2.665mg/L为阳性,或CA19-9值≥8.705U/ml为阳性联合诊断Ⅱ～Ⅳ期结直肠癌的准确度为75.6%,敏感度为88.3%,特异度为34.5%。结论:炎性介质和肿瘤标记物具有相关性,联合检测SAA和CA19-9筛选Ⅱ～Ⅳ期结直肠癌患者具有较高价值。Objective：To explore the diagnostic value of combined detection of inflammatory markers（CRP and SAA） and tumor marker（CEA,CA19-9 and CA72-4） in the preoperative staging of colorectal cancer（CRC）.Methods：Levels of CRP,SAA,CEA,CA19-9 and CA72-4 were tested for 130 CRC patients preoperatively,and they were analyzed against stage.Results：SAA showed correlation with CRP and CEA,of which the correlation coefficient was 0.647（P=0.000）and 0.295（P=0.001）.Serum levels of CRP,SAA and CA19-9 were associated with stage.Serum levels of CRP（P=0.046）,SAA（P=0.020） and CA19-9（P=0.017）had significant differences between stages.To select patients staging Ⅱ-Ⅳ,the ROC curve of SAA and CA19-9 were settled,of which the area under curve were 0.674（P=0.005） and 0.664（P=0.008）.To obtain the accuracy,sensitivity and specificity were 75.6%,88.3% and 34.5% respectively,while the cutoff point of SAA was defined as 2.665mg/L or which of CA19-9 was 8.705U/ml.Conclusion：CRP shows correlation with SAA,the combination of SAA and CRP is important in selecting stage Ⅱ to Ⅳ CRC patients.

关 键 词：结直肠肿瘤 肿瘤分期 C反应蛋白 血清淀粉样蛋白A CA19-9 

分 类 号：R735.3[医药卫生—肿瘤]