血浆纤维蛋白原与肿瘤标记物CEA、CA12-5和CA19-9术前联合评估结直肠癌肿瘤分期的价值  

Value of Plasma Fibrinogen in Combination with Tumor Markers CEA,CA12-5 and CA19-9 to Preoperatively Assess the Tumor Stage of Colorectal Cancer

作　　者：李文博 金头峰 LI Wen-bo;JIN Tou-feng(Department of Gastrointestinal Surgery,Affiliated Hospital to Yanbian University,Yanji,Jilin,133000,China)

机构地区：[1]延边大学附属医院胃肠外科,吉林延吉133000

出　　处：《中国血液流变学杂志》2023年第1期100-103,119,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨运用血浆纤维蛋白原(FBG)与肿瘤标记物癌胚抗原(CEA)、糖类抗原CA12-5、糖类抗原CA19-9术前联合评估结直肠癌肿瘤分期的价值。方法纳人113例结直肠癌患者,于术前测定血清CEA、CA12-5、CA19-9及FBG的水平,与术后病理分期进行比较,并建立诊断Ⅱ-Ⅳ期结直肠癌的ROC曲线,进行诊断实验分析。结果术前FBG与CA12-5呈正相关(r=0.204,P=0.031),CEA与CA19-9呈正相关(r=0.44,P=0.000);CEA(P=0.015)、CA19-9(P=0.037)、FBG(P=0.045)在不同TNM分期之间差异有统计学意义;建立CEA、CA19-9和FBG诊断Ⅱ-Ⅳ期结直肠癌的ROC曲线,CEA、CA19-9和FBG的ROC曲线下面积(AUC)分别为0.634(P=0.072),0.711(P=0.005),0.671(P=0.022),CEA的AUC差异无统计学意义;以血清CA19-9>4.95U/mL为阳性分别诊断Ⅱ-Ⅳ期结直肠癌敏感度84.2%,特异度50.0%,准确度55.8%;血浆FBG>3.95g/L为阳性时分别诊断Ⅱ-Ⅳ期结直肠癌敏感度48.4%,特异度94.4%,准确度78.8%;两项指标联合检测时敏感度90.5%,特异度50.0%,准确度84.1%。结论血浆FBG、肿瘤标记物CEA、CA12-5和CA19-9与结直肠癌病理分期具有相关性,联合检测CA19-9和FBG对Ⅱ-Ⅳ期结直肠癌的术前诊断具有一定价值。Objective To investigate the value of using plasma fibrinogen(FBG)in combination with tumor markers carcinoembryonic antigen(CEA)and glycoantigens CA12-5 and CA19-9 to preoperatively assess the tumor stage of colorectal cancer.Methods 113 patients with colorectal cancer were included,and the levels of serum CEA,CA12-5,CA19-9 and FBG were measured preoperatively and compared with postoperative pathological staging,and ROC curves for diagnosing stageⅡ-Ⅳcolorectal cancer were established for diagnostic experimental analysis.Results Preoperative FBG was positively correlated with CA12-5(r=0.204,P=0.031),and CEA was positively correlated with CA19-9(r=0.44,P=0.000).CEA(P=0.015),CA19-9(P=0.037)and FBG(P=0.045)showed statistically significant differences between different TNM stages.The ROC curves of CEA,CA19-9 and FBG for the diagnosis of stageⅡ-Ⅳcolorectal cancer were established,and the area under the ROC curves(AUC)of CEA,CA19-9 and FBG were 0.634(P=0.072),0.711(P=0.005),0.671(P=0.022),respectively,and the AUC of CEA was not statistically significant.The sensitivity,specificity and accuracy of CEA were 84.2%,50.0%and 55.8%,respectively,for the diagnosis of stageⅡ-Ⅳcolorectal cancer when serum CA19-9>4.95 U/mL was positive.The sensitivity,specificity and accuracy of serum FBG>3.95 g/L was 48.4%,94.4%and 78.8%,respectively,for the diagnosis of stageⅡ-Ⅳcolorectal cancer.The sensitivity,specificity and accuracy of the two indicators were 90.5%,50.5%and 84.1%,respectively,when they were combined.Conclusion Plasma FBG,tumor markers CEA,CA12-5 and CA19-9 are correlated with pathological stage of colorectal cancer,and the combined detection of CA19-9 and FBG is valuable for preoperative diagnosis of stageⅡ-Ⅳcolorectal cancer.

关 键 词：结直肠癌 CEA CA19-9 CA12-5 肿瘤分期 纤维蛋白原 

分 类 号：R735.3[医药卫生—肿瘤]