D-二聚体联合糖类抗原199在结直肠癌与肠息肉鉴别诊断中的价值  

The value of D-dimer combined with CA199 in differential diagnosis of colorectal cancer and intestinal polyps

作　　者：张红卫[1] 袁宁 孟丽[3] 李秀娟 张志军[5] ZHANG Hongwei;YUAN Ning;MENG Li;LI Xiujuan;ZHANG Zhijun(Department of UItrasonic Diagnosis,Taian Maternal and Child Health Hospital,Taian,Shandong 271000,China;Department of Clinical Laboratory,Fourth Teaching Hospital of Tian Jin University of TCM,Binhai New Area,Tianjin 300450,China;Department of Radiotherapy,The Affiliated Taian City Central Hospital of Qingdao University,Taian,Shandong 271000,China;Department of Medical Imaging,The Affiliated Taian City Central Hospital of Qingdao University,Taian,Shandong 271000,China;Department of Clinical Laboratory,The Affiliated Taian City Central Hospital of Qingdao University,Taian,Shandong 271000,China)

机构地区：[1]泰安市妇幼保健院超声科,山东泰安271000 [2]天津中医药大学第四附属医院检验科,天津300450 [3]青岛大学附属泰安市中心医院放疗科,山东泰安271000 [4]青岛大学附属泰安市中心医院医学影像中心,山东泰安271000 [5]青岛大学附属泰安市中心医院临床检验中心,山东泰安271000

出　　处：《现代医学与健康研究电子杂志》2022年第17期1-5,共5页Modern Medicine and Health Research

基　　金：青岛大学附属泰安市中心医院苗圃项目(编号:2022MPM01)。

摘　　要：目的对比研究D-二聚体(D-D)和糖类抗原199(CA199)联合检测的结果,进一步分析在结直肠癌与肠息肉鉴别效能和诊断价值。方法选取2019年3月至2021年3月青岛大学附属泰安市中心医院收治的经病理诊断确诊的912例结直肠癌和922例肠息肉患者作为研究对象(试验组),并纳入同期的966例健康志愿者为对照组,进行回顾性分析研究。比较三组受试者的D-D和CA199的表达水平,绘制受试者工作特征(ROC)曲线评估单独和联合检测对结直肠癌与肠息肉的诊断及鉴别诊断的效能。结果与对照组相比,结直肠癌组患者D-D和CA199水平显着升高(均P<0.0001),肠息肉组患者D-D和CA199水平也明显升高(P值分别为0.018与0.0006),而且D-D和CA199均能显著区分结直肠癌组与肠息肉组。ROC曲线分析显示,DD和CA199联合检测筛查结直肠癌的AUC为0.815,敏感度为64.7%,特异度为92.00%,联合检测用于区分结直肠癌组与肠息肉组的AUC为0.765,敏感度为68.3%,特异度为73.9%。结论D-D和CA199联合检测对结直肠癌筛查具有较高的临床应用价值,并且能较好地区分结直肠癌与肠息肉,可为结直肠癌的筛查及与肠息肉鉴别诊断提供参考。Objective To explore the value of combined detection of D-dimer and carbohydrate antigen 199(CA199)in the differential diagnosis of colorectal cancer and intestinal polyps.Methods The data of 912 patients with colorectal cancer and 922 patients with intestinal polyps diagnosed by pathology in the Affiliated Taian City Central Hospital of Qingdao University were retrospectively analyzed from March 2019 to March 2021.966 healthy volunteers in the same period were included as the control group And Conduct retrospective studies.The expression levels of D-dimer and CA199 in three groups were compared,and the receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of single and combined detection in the diagnosis and differential diagnosis of colorectal cancer and intestinal polyps.Results Compared with the control group,the levels of D-dimer and CA199 in colorectal cancer group were significantly higher(P<0.0001),and those in intestinal polyp group were also significantly higher than those in intestinal polyp group(P=0.018,P>0.0006).D-dimer and CA199 could significantly distinguish colorectal cancer group from intestinal polyp group.ROC curve analysis showed that the AUC of DD and CA199 for colorectal cancer screening was 0.815,the sensitivity was 64.7%,and the specificity was 92.00%.The AUC for distinguishing colorectal cancer and intestinal polyps was 0.765,the sensitivity was 68.3%,and the specificity was 73.9%.Conclusion The combined detection of D-dimer and CA199 has high clinical value in colorectal cancer screening and better distinguishing colorectal cancer from intestinal polyps,which can provide reference for the screening and differential diagnosis of colorectal cancer and intestinal polyps.

关 键 词：D-二聚体 糖类抗原199 结直肠癌 肠息肉 

分 类 号：R446.61[医药卫生—诊断学]