肿瘤4项联合NLR、CEA在结肠癌中的诊断价值及与临床分期的相关性  

The diagnostic value of four tumor items combined with NLR and CEA in patients with colon cancer and their correlation with clinical stage

作　　者：廖玮浩 张雷 杜建飞 袁艳花 陈彩娟 LIAO Weihao;ZHANG Lei;DU JIanfei;YUAN Yanhua;CHEN Caijuan(Department of Oncology,Xi′an Chang′an Hospital,Xi′an,Shaanxi 710016,China)

机构地区：[1]西安长安医院肿瘤科,陕西西安710016

出　　处：《检验医学与临床》2021年第2期165-167,171,共4页Laboratory Medicine and Clinic

基　　金：陕西省咸阳市2014年科学技术研究计划(2014K04-10)。

摘　　要：目的探讨血清肿瘤4项[细胞角蛋白19片段(CYFRA21-1)、糖类抗原125(CA125)、糖类抗原15-3(CA15-3)、糖类抗原19-9(CA19-9)]联合中性粒细胞计数/淋巴细胞计数比率(NLR)、癌胚抗原(CEA)在结肠癌中的诊断价值,并分析血清肿瘤4项和NLR、CEA与结肠癌临床分期的相关性。方法选取进行结肠组织活检的284例患者为研究对象,根据病理诊断结果,其中良性病变203例(良性病变组),结肠癌81例(病例组)。比较两组患者CYFRA21-1、CA125、CA15-3、CA19-9、NLR、CEA的水平。采用受试者工作特征曲线(ROC曲线)分析血清肿瘤4项(CYFRA21-1、CA125、CA15-3、CA19-9)联合NLR、CEA在结肠癌诊断中的价值;采用Spearman相关分析血清肿瘤4项和NLR、CEA表达与结肠癌临床分期的相关性。结果病例组CYFRA21-1、CA125、CA15-3、CA19-9和NLR、CEA均高于良性病变组(P<0.05)。NLR、CEA联合血清肿瘤4项(CYFRA21-1、CA125、CA15-3、CA19-9)诊断结肠癌的灵敏度(89.71%)、特异度(90.08%)、准确率(92.31%)均高于各项指标单独检测。NLR(r=0.813,P=0.016)、CEA(r=0.881,P=0.013)、CYFRA21-1(r=0.853,P=0.014)、CA125(r=0.857,P=0.014)、CA15-3(r=0.851,P=0.014)、CA19-9(r=0.829,P=0.015)与临床分期呈正相关(P<0.05)。结论血清肿瘤4项和NLR、CEA与结肠癌临床分期密切相关,且血清肿瘤4项和NLR、CEA联合检测在结肠癌早期诊断中具有较高价值,值得临床推广使用。Objective To observe the diagnostic value of serum four tumor items[cytokeratin 19 fragment(CYFRA21-1),carbohydrate antigen 125(CA125),CA15-3,CA19-9]combined with neutrophil count/lymphocyte count rate(NLR)and carcinoembryonic antigen(CEA)in colorectal cancer,and to analyze the correlation between four tumor items,NLR,CEA and clinical stage of colon cancer.Methods A total of 284 cases who conducted colonic biopsies were selected as the study objects,and according to the pathological diagnosis results,there were 203 cases of benign lesions(benign group),81 cases of malignant lesions(case group).Levels of CYFRA21-1,CA125,CA15-3,CA19-9 and CEA were compared between the two groups.The value of four serum tumor items(CYFRA21-1,CA125,CA15-3,CA19-9)combined with NLR and CEA in the diagnosis of colon cancer were analyzed by ROC curve.The correlations between the expression of four serum tumor items,NLR,CEA and clinical stage of colon cancer were observed.Results Levels of CYFRA21-1,CA125,CA15-3,CA19-9,NLR and CEA in case group were significantly higher than those in benign group(P<0.05).The diagnostic sensitivity(89.71%),specificity(90.08%),accuracy(92.31%)of combined detection of CYFRA21-1,CA125,CA15-3,CA19-9,NLR and CEA were significantly higher than those of single detection of each indicator.NLR(r=0.813,P=0.016),CEA(r=0.881,P=0.013),CYFRA21-1(r=0.853,P=0.014),CA125(r=0.857,P=0.014),CA15-3(r=0.851,P=0.014),CA19-9(r=0.829,P=0.015)were positively correlated with clinical stage.Conclusion The four items of serum tumor,NLR and CEA may play an important role in diagnosis of colon cancer,and they are closely related to the clinical stage,which is worthy of promotion in clinic.

关 键 词：细胞角蛋白19片段 中性粒细胞计数/淋巴细胞计数比率 癌胚抗原 结肠癌 诊断价值 

分 类 号：R735.35[医药卫生—肿瘤]