CT仿真结肠镜联合肿瘤标志物检测在结直肠癌中的诊断价值  

Diagnostic Value of CT Virtual Colonoscopy Combined with Tumor Marker Detection in Colorectal Cancer

作　　者：李季[1] 沈艳 姜研[3] LI Ji;SHEN Yan;JIANG Yan(Department of General Oncology,Bengbu First People′s Hospital,Bengbu 233000,China;Department of CT,Bengbu First People′s Hospital,Bengbu 233000,China;Department of MRI,Bengbu First People′s Hospital,Bengbu 233000,China)

机构地区：[1]蚌埠市第一人民医院普外肿瘤科,安徽蚌埠233000 [2]蚌埠市第一人民医院CT室,安徽蚌埠233000 [3]蚌埠市第一人民医院磁共振室,安徽蚌埠233000

出　　处：《医学综述》2021年第5期1032-1036,共5页Medical Recapitulate

摘　　要：目的探讨CT仿真结肠镜联合肿瘤标志物检测在结直肠癌中的诊断价值。方法选择2015年2月至2019年10月蚌埠市第一人民医院收治的164例消化道疾病患者为研究对象,入组患者均行CT仿真结肠镜检查,检测血清中癌胚抗原(CEA)、糖类抗原(CA)19-9、CA50、CA242水平。以结直肠癌病理检查结果为金标准,分析CT仿真结肠镜、CEA、CA19-9、CA50、CA242单独及联合检测结直肠癌的诊断价值。结果164例受试者中有80例诊断为结直肠癌。结直肠癌组血清CEA、CA19-9、CA50、CA242水平均显著高于对照组[(67.53±4.52)μg/L比(3.11±0.23)μg/L,(104.23±6.94)kU/L比(9.42±0.62)kU/L,(125.45±8.36)kU/L比(7.85±0.52)kU/L,(15.44±1.02)kU/L比(2.32±0.15)kU/L](P<0.01)。二元Logistic回归分析结果显示,CT仿真结肠镜检查、血清CEA、CA19-9、CA50、CA242均为结直肠癌诊断的独立影响因素(P<0.01)。受试者工作特征曲线分析结果显示,CT仿真结肠镜检查、CEA、CA19-9、CA50、CA242及联合预测因子的曲线下面积分别为0.938、0.841、0.800、0.847、0.788、0.977,差异均有统计学意义(P<0.01)。联合检测用于结直肠癌诊断的准确度和灵敏度最高,分别为96.95%、97.50%。结论CT仿真结肠镜联合血清肿瘤标志物检测能够提高结直肠癌的临床诊断效能。Objective To explore the diagnostic value of CT simulated colonoscopy combined with tumor marker detection in colorectal cancer.Methods A total of 164 patients with digestive tract diseases admitted to Bengbu First People′s Hospital from Feb.2015 to Oct.2019 were included.All the enrolled patients underwent CT simulated colonoscopy,and the serum levels of carcino-embryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA50 and CA242 were detected.The diagnostic value of CT simulated colonoscopy,CEA,CA19-9,CA50 and CA242 alone and in combination was analyzed using the pathological examination results of colorectal cancer as the gold standard.Results Of the 164 subjects,80 were diagnosed with colorectal cancer.The serum CEA,CA19-9,CA50 and CA242 levels of the colorectal cancer group were significantly higher than those of the control group[(67.53±4.52)μg/L vs(3.11±0.23)μg/L,(104.23±6.94)kU/L vs(9.42±0.62)kU/L,(125.45±8.36)kU/L vs(7.85±0.52)kU/L,(15.44±1.02)kU/L vs(2.32±0.15)kU/L](P<0.01).Binary Logistic regression analysis showed that CT simulated colonoscopy,serum CEA,CA19-9,CA50 and CA242 were independent influencing factors for colorectal cancer(P<0.01).The receiver operating curve analysis results showed that the CT simulated colonoscopy,CEA,CA19-9,CA50,CA242 and the combined predictor had an area under the curve of 0.938,0.841,0.800,0.847,0.788 and 0.977,respectively,the differences of which were statistically significant(P<0.01).The combined detection showed the highest accuracy and sensitivity in the diagnosis of colorectal cancer(96.95%and 97.50%respectively).Conclusion CT simulation colonoscopy combined with serum tumor markers detection can improve the clinical diagnostic efficacy of colorectal cancer.

关 键 词：结直肠癌 CT仿真结肠镜 肿瘤标志物 诊断效能 

分 类 号：R735.3[医药卫生—肿瘤]