循环肿瘤细胞联合癌胚抗原检测在Ⅰ、Ⅱ期结直肠癌诊断中的应用研究  

Application of circulating tumor cells combined with carcinoembryonic antigen in the diagnosis of stage Ⅰ and Ⅱ colorectal cancer

作　　者：蒋晓芬 邵传锋 张浩 杨丽娟[3] 王中林 潘杰 吴伟[4] JIANG Xiao-fen;SHAO Chuan-feng;ZHANG Hao(Department of Gastroenterology,Wenzhou Central Hospital,Wenzhou,Zhejiang 325000,Chin)

机构地区：[1]温州市中心医院消化内科,浙江温州325000 [2]乐清市人民医院药剂科,浙江温州325600 [3]温州医科大学附属第一医院内分泌科,浙江温州325000 [4]温州医科大学附属第一医院消化内科

出　　处：《中华全科医学》2018年第10期1653-1655,共3页Chinese Journal of General Practice

基　　金：2014年浙江省医药卫生科技项目(2014ZDA022)

摘　　要：目的分析循环肿瘤细胞(circulating tumor cells,CTC)联合癌胚抗原(carcinoembryonic antigen,CEA)检测在Ⅰ、Ⅱ期结直肠癌中的应用价值,为Ⅰ、Ⅱ期结直肠癌患者的临床治疗提供参考。方法选取2017年4—9月温州市中心医院收治的结直肠疾病患者121例,根据病理学诊断将其分Ⅰ、Ⅱ期结直肠癌患者和结直肠良性疾病患者,其中Ⅰ、Ⅱ期结直肠癌患者86例作为观察组,结直肠良性疾病患者35例作为对照组,分别检测患者血清中CTC和CEA水平,分析患者CTC计数与其临床资料的关系,并采用一致性检验比较CEA检测、CTC检测、CEA联合CTC检测对Ⅰ、Ⅱ期结直肠癌的诊断价值。结果不同CEA水平患者的CTC计数差异有统计学意义(均P<0.05),CEA检测结直肠癌的阳性率为47.67%(41/86),CTC检测结直肠的阳性率为72.09%(62/86),CTC联合CEA检测结直肠癌的阳性率为90.70%(78/86),一致性检验结果显示,CTC联合CEA检测的灵敏度、特异度、准确度及一致性均高于CEA及CTC单独检测。结论 CTC联合CEA检测在Ⅰ、Ⅱ期结直肠癌诊断中有较高应用价值。Objective To analyze the role of circulating tumor cells（ CTC） combined with carcinoembryonic antigen（ CEA） in the diagnosis of stage Ⅰ and Ⅱ colorectal cancer,and to provide reference for clinical treatment of patients with stage Ⅰ and Ⅱ colorectal cancer. Methods A total of 86 patients with colorectal disease were divided into observation group（ stage Ⅰ and Ⅱ colorectal cancer,n = 86） and control group（ benign colorectal disease,n = 35） who were diagnosed by pathological diagnosis in our hospital were selected from April,2017 to September,2017 as observation group,and 35 patients with health examination and colorectal benign in the same period were selected as control group.The level of CTC and CEA were examined. The relationship between CTC count and its clinical data was analyzed,and the diagnostic value of CEA detection,CTC detection and CEA combined with CTC detection in stage Ⅰ and Ⅱ colorectal cancer were compared. Results There were significant differences in CTC counts among patients with different CEA levels（ P 0. 05）. The positive rate of CEA detection was 47. 67%（ 41/86）. The positive rate of CTC detection was72. 09%（ 62/86）. The positive rate of CTC combined with CEA was 90. 70%（ 78/86）. The consistency test results showed that the sensitivity,specificity,accuracy and consistency of CTC combined with CEA detection were significantly higher than those of CEA and CTC detection. Conclusion The CTC combined with CEA has high application value in the diagnosis of colorectal cancer in stage Ⅰ and Ⅱ,which is worthy of clinical promotion.

关 键 词：循环肿瘤细胞 癌胚抗原 Ⅰ、Ⅱ期结直肠癌 诊断价值 

分 类 号：R735.37[医药卫生—肿瘤] R730.43[医药卫生—临床医学]