联合检测血清肿瘤标志物与M2-PK在结直肠癌筛查的价值  

Value of combined detection of serum tumor markers and M2-PK in colorectal cancer screening

作　　者：陈金锦[1] 蒋晓颖[1] 吴秋花[1] Jin-Jin Chen;Xiao-Ying Jiang;Qiu-Hua Wu(Clinical Laboratory,Huzhou First People’s Hospital,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市第一人民医院检验科,浙江湖州313000

出　　处：《世界华人消化杂志》2021年第24期1441-1446,共6页World Chinese Journal of Digestology

摘　　要：背景结直肠癌恶性程度高,发病率明显增加,其致死率也呈逐年上升趋势,临床重视对结直肠癌的早期筛查,但因结直肠癌临床症状无特异性且发生机制复杂,早期不易筛查.目的探讨血清糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)、癌胚抗原(carcinoembryonic antigen,CEA)联合肿瘤M2型丙酮酸激酶(pyruvate kinase M2,M2-PK)检测对结直肠癌(colorectal cancer,CRC)的筛查价值.方法选取2018-01-01/2020-10-10本院就诊的80例结直肠癌患者为直肠癌组,同期本院就诊的结直肠良性疾病患者75例为良性疾病组,另选取同期健康体检者90例为健康对照组.所有受试者均进行血清CA19-9、CEA及M2-PK检测,比较三组患者间血清CA19-9、CEA及M2-PK水平差异,并以ROC曲线分析血清CA19-9、CEA及M2-PK对结直肠癌的筛查价值.结果单因素方差结果结果显示,三组血清中CEA、CA19-9和TuM2-PK差异具有统计学意义(P<0.05);且结直肠癌组血清CEA、CA19-9和TuM2-PK表达水平均明显高于良性疾病组及对照组(P<0.05).ROC结果显示,血清CEA、CA19-9和TuM2-PK诊断结直肠癌的AUC分别为0.72、0.69、0.85.联合诊断结果显示,CEA+CA19-9+TuM2-PK三者联合检测方案的灵敏度为90%,显著高于其他组合,差异有统计学意义(P<0.05).结论血清肿瘤标志物联合M2-PK检测可有效提高结直肠癌诊断的灵敏度,对于结直肠癌的早期筛查具有重要作用.BACKGROUND Colorectal cancer(CRC)is a highly malignant tumor with a significant increase in incidence and fatality rate year by year.Great attention has been paid to early screening for colorectal cancer.However,due to the non-specific clinical symptoms and complicated mechanisms of CRC,its early screening is not easy.AIM To explore the value of serum carbohydrate antigen 19-9(CA19-9)and carcinoembryonic antigen(CEA)combined with tumor M2 pyruvate kinase(M2-PK)in the screening of CRC.METHODS Eighty patients with CRC and 75 patients with benign colorectal diseases treated at our hospital from January 1,2018 to October 10,2020 were selected.In addition,90 healthy controls were also included.All subjects were tested for serum CA19-9,CEA,and M2-PK.The differences in serum CA19-9,CEA,and M2-PK levels between the three groups were compared,and the receiver operating characteristic(ROC)curve was used to assess the performance of serum CA19-9,CEA,and M2-PK levels,either alone or in combination,in CRC screening.RESULTS The results of one-way variance showed that the differences in serum CEA,CA19-9,and TuM2-PK were statistically significant among the three groups(P<0.05);the levels of serum CEA,CA19-9,and TuM2-PK in the CRC group were significantly higher than those of the other two groups(P<0.05).ROC curve analysis showed that the area under the ROC curve(AUC)values of serum CEA,CA19-9,and TuM2-PK for the diagnosis of CRC were 0.72,0.69,and 0.85,respectively.The sensitivity of combined detection of CEA+CA19-9+TuM2-PK was 90%,which was significantly higher than that of other combinations(P<0.05).CONCLUSION The detection of serum tumor markers combined with M2-PK can effectively improve the sensitivity of the diagnosis of CRC,and may play an important role in the early screening of this malignancy.

关 键 词：结直肠癌 丙酮酸激酶M2 癌胚抗原 糖类抗原CA19-9 肿瘤标志物 联合检测 

分 类 号：R735.34[医药卫生—肿瘤]