红细胞分布宽度、白蛋白、血小板/淋巴细胞比值及癌胚抗原在低癌胚抗原结直肠癌筛查中的预测价值  

Predictive value of red blood cell distribution width,albumin,platelet/lymphocyte ratio,and carcinoembryonic antigen on screening patients with low CEA level colorectal cancer

作　　者：戴龙飞 任之尧 王旭[1] 李霆[1] 陈博[1] 杨文奇[1] DAI Longfei;REN Zhiyao;WANG Xu;LI Ting;CHEN Bo;YANG Wenqi(Department of Gastrointestinal Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230032,China)

机构地区：[1]安徽医科大学第一附属医院胃肠外科,安徽合肥230032

出　　处：《安徽医药》2023年第11期2220-2223,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的评估红细胞分布宽度(RDW)、白蛋白(ALB)、血小板/淋巴细胞比值(PLR)及癌胚抗原(CEA)在低CEA结直肠癌筛查中的预测价值。方法选取2017年7月至2020年10月在安徽医科大学第一附属医院就诊或体检者800例,其中低CEA结直肠癌病人300例;非结直肠癌病人500例(包括结直肠良性肿瘤病人250例和健康体检者250例)。采用非参数Mann-Whitney U检验,选出有组间差异的血清学指标。通过多因素logistic回归及受试者操作特征(ROC)曲线分析血清标志物的预测价值。结果非结直肠癌组与低CEA结直肠癌组RDW[42.70(40.80,44.80)比43.70(41.90,46.20)]、血小板分布宽度(PDW)[13.70(12.10,15.80)比13.10(11.60,15.10)]、血小板平均容积(MPV)[11.30(10.60,12.20)比10.80(10.20,11.80)]、ALB[44.80(42.33,46.80)g/L比41.70(38.70,44.30)g/L]、前白蛋白浓度(PA)[277.00(242.00,310.50)比244.00(199.00,286.25)]、糖类抗原(CA199)[9.94(6.42,15.14)μg/L比8.77(5.68,13.62)μg/L]、CEA[1.60(1.00,2.30)μg/L比2.10(1.46,3.10)μg/L]、中性粒细胞/淋巴细胞比值(NLR)[1.69(1.36,2.20)比2.09(1.65,2.85)]、PLR[112.90(88.91,140.25)比136.18(106.54,187.12)]和单核细胞/淋巴细胞比值(MLR)[0.17(0.14,0.22)比0.23(0.17,0.31)]差异有统计学意义。而RDW、ALB、PLR及CEA是低CEA水平结直肠癌的独立危险因素。RDW+ALB+CEA+PLR联合筛查低CEA结直肠癌价值最高(AUC=0.77)。当RDW+ALB+CEA+PLR>−0.37,体检者患结直肠癌的可能性大。结论RDW+ALB+CEA+PLR联合筛查低CEA结直肠癌病人价值最高,其筛查价值优于单个标志物。作为一种更敏感和更具成本效益的策略,这种方法可以在常规结直肠癌筛查中进行。Objective To assess the predictive value of red blood cell distribution width(RDW),albumin(ALB),platelet/lymphocyte ratio(PLR),and carcinoembryonic antigen(CEA)on screening patients with low CEA level colorectal cancer.Methods A total of 800 patients who attended the First Affiliated Hospital of Anhui Medical University from July 2017 to October 2020 were retrospectively collected,including 300 patients with low-CEA colorectal cancer,and 500 patients with non-colorectal cancer(250 patients with benign colorectal tumors and 250 healthy physical examiners).A nonparametric Mann-Whitney U test was performed between the two groups to select the serological indicators with intergroup differences.Finally,the predictive value of serologic markers was explored by multifactorial logistic regression analysis and ROC analysis.Results Red blood cell distribution width(RDW)[42.70(40.80,44.80)vs.43.70(41.90,46.20)],platelet distribution width(PDW)[13.70(12.10,15.80)vs.13.10(11.60,15.10)],mean platelet volume(MPV)[11.30(10.60,12.20)vs.10.80(10.20,11.80)],albumin concentration(ALB)[44.80(42.33,46.80)g/L vs.41.70(38.70,44.30)g/L],prealbumin concentration(PA)[277.00(242.00,310.50)vs.244.00(199.00,286.25)],glycocalyx antigen(CA199)[9.94(6.42,15.14)μg/L vs.8.77(5.68,13.62)μg/L],carcinoembryonic antigen(CEA)[1.60(1.00,2.30)μg/L vs.2.10(1.46,3.10)μg/L],neutrophil/lymphocyte ratio(NLR)[1.69(1.36,2.20)vs.2.09(1.65,2.85)],platelet/lymphocyte ratio(PLR)[112.90(88.91,140.25)vs.136.18(106.54,187.12)]and monocyte/lymphocyte ratio(MLR)[0.17(0.14,0.22)vs.0.23(0.17,0.31)]were statistically significantly different.While RDW,ALB,PLR,and CEA were independent risk factors for colorectal cancer with low CEA levels,the combination of RDW+ALB+CEA+PLR had the highest screening value for colorectal cancer with low CEA(AUC=0.77).When RDW+ALB+CEA+PLR>−0.37,physical examiners were more likely to have colorectal cancer.Conclusions The combination of RDW+ALB+CEA+PLR has the highest value for screening patients with low CEA level colorectal cancer and it

关 键 词：结直肠肿瘤 早期诊断 癌胚抗原 血清指标 筛查 

分 类 号：R735.34[医药卫生—肿瘤]