多种血清肿瘤标记物联合粪便隐血检测在早期结肠癌诊断中的应用价值  

Application of multiple serum tumor markers combined with fecal occult blood detection in early diagnosis of colon cancer

作　　者：王鹏达 辛瑞娟[1] 李西梅[1] WANG Pengda;XIN Ruijuan;LI Ximei(People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第12期1024-1027,共4页Ningxia Medical Journal

基　　金：宁夏医科大学校级科研项目(XM2023068)。

摘　　要：目的研究分析多种血清肿瘤标记物联合粪便隐血检测在早期结肠癌诊断中的应用价值。方法选取早期结肠癌患者65例为结肠癌组,54例结肠炎患者为结肠炎组,另选同期进行健康体检的健康受试者50例为对照组。对结肠癌组、结肠炎组患者及对照组受试者的血清肿瘤标志物及粪便隐血水平进行检测对比,并对单个指标及联合指标检出阳性率进行统计对比分析,同时分析对比肿瘤标志物和粪便隐血检测对于结肠癌诊断的灵敏度、特异度、ROC曲线下面积(AUC)。结果结肠癌组患者的组织多肽抗原(TPA)、癌胚抗原(CEA)、糖链抗原199(CA199)、甲胎蛋白(AFP)、粪便隐血水平高于结肠炎组且高于对照组,差异有统计学意义(P<0.05)。结肠癌组患者各指标检测阳性率高于结肠炎组和对照组,多种肿瘤标志物与粪便隐血联合检测阳性率要高于单个指标检测,差异有统计学意义(P<0.05)。经logistic多因素分析,TPA、CEA、AFP、CA199、粪便隐血均为结肠癌发病的危险因素(P<0.05)。血清肿瘤标志物与粪隐血联合检测对结肠癌诊断的灵敏度、特异度、AUC高于单个指标检测(P<0.05)。结论TPA、CEA、AFP、CA199与粪便隐血在结肠癌患者中呈现阳性表达,且多种血肿瘤标志物联合粪便隐血检测能够为早期结肠癌患者的诊断提供参考依据。Objective To study the application value of multiple serum tumor markers combined with fecal occult blood detection in the early diagnosis of colon cancer.Methods 65 patients with early colon cancer were selected as colon cancer group,54 patients with colitis were selected as colitis group,and 50 healthy subjects who underwent physical examination during the same period were selected as control group.The serum tumor markers and fecal occult blood levels of patients were detected and compared,and the positive rate of single and combined indicators were statistically compared and analyzed.Meanwhile,the sensitivity,specificity and area under the curve(AUC)of tumor markers and occult blood detection for the diagnosis of colon cancer were analyzed and compared.Results The levels of tissue polypeptide antigen(TPA),carcinoembryonic antigen(CEA),Carbohydrate antigen 199(CA199),alpha-fetoprotein(AFP)and fecal occulted blood in colon cancer group were higher than those in colitis group and control group,and the difference between groups was statistically significant(P<0.05).The positive rate of all indicators in colon cancer group was higher than that in colitis group and control group,and the positive rate of multiple tumor markers combined with fecal occult blood was higher than that of single indicator,the difference was statistically significant(P<0.05).Logistic multivariate analysis showed that TPA,CEA,AFP,CA199 and fecal occult blood were all risk factors for colon cancer(P<0.05).The sensitivity,specificity and AUC of the combined detection of tumor markers and fecal occult blood were higher than those of the single detection(P<0.05).Conclusion TPA,CEA,AFP,CA199 and fecal occult blood show positive expression in patients with colon cancer,and multiple blood tumor markers combined with fecal occult blood detection can provide reference for the diagnosis of early colon cancer patients.

关 键 词：早期结肠癌 组织多肽抗原 癌胚抗原 甲胎蛋白 糖链抗原199 粪便隐血 诊断价值 

分 类 号：R735.35[医药卫生—肿瘤]