血清cfDNA、CEA、CA19-9及粪便隐血试验联合诊断结直肠癌的临床价值  

Clinical Value of Serum cfDNA,CEA,CA19-9 and Fecal Occult Blood Test in Diagnosis of Colorectal Cancer

作　　者：李坤朋 张献波 李焕 LI Kun-peng;ZHANG Xian-bo;LI Huan(Department of Laboratory Medicine,Nanyang Second People's Hospital,Nanyang,Henan 473000)

机构地区：[1]南阳市第二人民医院检验科,河南南阳473000

出　　处：《中国肛肠病杂志》2025年第1期1-4,共4页Chinese Journal of Coloproctology

摘　　要：目的:探讨血清游离脱氧核糖核酸(cfDNA)、癌胚抗原(CEA)、糖蛋白抗原19-9(CA19-9)及粪便隐血试验联合诊断结直肠癌的临床价值。方法:回顾性选取于我院2022年9月至2023年9月就诊的结直肠癌患者86例为观察组,同时选取于我院体检结果为正常的健康人群86名为对照组,比较2组血清cfDNA、CEA、CA19-9水平及粪便隐血阳性率,分析血清cfDNA、CEA、CA19-9水平和粪便隐血阳性率与结直肠癌的相关性,采取受试者工作特征曲线(ROC)评价分析血清cfDNA、CEA、CA19-9水平和粪便隐血阳性率单项检测与联合检测对结直肠癌的诊断价值。结果:观察组患者血清cfDNA、CEA、CA19-9水平及粪便隐血阳性率均高于对照组(P<0.05);血清cfDNA(r=0.671,P<0.001)、CEA(r=0.540,P<0.001)、CA19-9水平(r=0.623,P<0.001)和粪便隐血阳性率(r=0.712,P<0.001)均与结直肠癌呈正相关;ROC曲线显示,血清cfDNA、CEA、CA19-9、粪便隐血阳性率单项检测及四项联合检测的AUC分别为0.853、0.811、0.807、0.843、0.956,灵敏度分别为89.5%、84.9%、79.1%、70.9%、90.7%,特异度分别为86.0%、82.6%、82.6%、97.3%、88.4%。结论:血清cfDNA、CEA、CA19-9水平和粪便隐血阳性率联合检测能够提高诊断结直肠癌的灵敏度,具有较高的诊断价值,能够为临床提供参考。Objective To investigate the clinical value of serum cell-free deoxyribonucleic acid(cfDNA),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and fecal occult blood test(FOBT)test in the diagnosis of colorectal cancer.Methods A total of 86 patients with colorectal cancer treated in our hospital from September 2022 to September 2023 were retrospectively selected as the observation group,and 86 healthy people with normal physical examination results in our hospital were selected as the control group.The serum levels of cfDNA,CEA,CA19-9 and the positive rate of FOBT were compared between the two groups.The correlation between serum levels of cfDNA,CEA,CA19-9,the positive rate of FOBT and colorectal cancer was analyzed.The receiver operating characteristic curve(ROC)was used to evaluate and analyze the diagnostic value of single detection and combined detection of serum levels of cfDNA,CEA,CA19-9 and the positive rate of FOBT for colorectal cancer.Results The serum levels of cfDNA,CEA,CA19-9 and the positive rate of FOBT in the observation group were higher than those in the control group(P<0.05).The serum levels of cfDNA(r=0.671,P<0.001),CEA(r=0.540,P<0.001),CA19-9(r=0.623,P<0.001)and the positive rate of FOBT(r=0.712,P<0.001)were positively correlated with colorectal cancer.The ROC curve showed that the AUC of single detection of serum cfDNA,CEA,CA19-9,the positive rate of FOBT and the combined detection of the four items were 0.853,0.811,0.807,0.843 and 0.956 respectively,and the sensitivity was 89.5%,84.9%,79.1%,70.9%and 90.7%,respectively.The specificity was 86.0%,82.6%,82.6%,97.3%and 88.4%,respectively.Conclusion The combined detection of the serum levels of cfDNA,CEA,CA19-9 and the positive rate of FOBT has the high diagnostic value which can improve the sensitivity in the diagnosis of colorectal cancer and can provide a reference for the clinic.

关 键 词：结直肠癌 血清游离脱氧核糖核酸 癌胚抗原 糖蛋白抗原19-9 粪便隐血 诊断 

分 类 号：R735.34[医药卫生—肿瘤]