肿瘤标志物与中性粒细胞/淋巴细胞对直肠癌早期诊断价值  

Early Diagnostic Value of Tumor Markers and Neutrophil/Lymphocyte in Rectal Cancer

作　　者：李秀娟 南京柱 魏雪梅 鲁鸿昊 王雪敏 李蓉 张旭[3] LI Xiujuan;NAN Jingzhu;WEI Xuemei;LU Honghao;WANG Xuemin;LI Rong;ZHANG Xu(Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Beijing Anzhen hospital,Capital Medical University,Beijing 100029,China;The 1st Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Beijing Tiantan hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050 [2]首都医科大学附属北京安贞医院,北京100029 [3]解放军总医院第一医学中心,北京100853 [4]首都医科大学附属北京天坛医院,北京100070

出　　处：《北华大学学报(自然科学版)》2025年第3期345-349,共5页Journal of Beihua University(Natural Science)

基　　金：科技部国家重点研发计划项目(2021YFC1005300)。

摘　　要：目的探讨直肠良、恶性肿瘤间肿瘤标志物与中性粒细胞/淋巴细胞(Neutrophil to lymphocyte ratio,NLR)差异,找出对直肠癌早期诊断有意义的指标。方法选择直肠癌患者126例,直肠良性肿瘤患者92例。收集相关肿瘤标志物癌胚抗原(Carcinoembryonic antigen,CEA)、细胞角质素片段19(Cytokerantin-fragment-19,CYFRA21-1)、铁蛋白(Ferritin,Ferr)、糖类抗原199(Carbohydrate antigen199,CA199)、糖类抗原724(Carbohydrate antigen724,CA724)水平及术前NLR水平,分析各指标在两组间的差异,对有差异的指标建立二元Logistic回归模型,绘制受试者操作特征曲线(Receiver Operating Characteristic,ROC),并对各指标进行相关性分析。结果恶性组患者中年龄、CEA、CYFRA21-1、NLR水平显著高于良性组,恶性组患者Ferr水平显著低于良性组(P<0.05)。CEA、CYFRA21-1、NLR为直肠癌危险性因素,3者比值比(Odds Ratio,OR)分别为1.255(95%CI:1.088~1.446,P=0.002)、1.602(95%CI:1.143~2.245,P=0.006)、1.739(95%CI:1.003~3.015,P=0.049)。Ferr为直肠癌保护性因素,OR为0.996(95%CI:0.993~0.998,P=0.001)。CEA、CYFRA21-1、Ferr、NLR对直肠癌预测概率分别为74.1%、69.2%、72.7%、65.0%,4者联合的预测概率为83.7%。其中,4者联合检测的灵敏度为0.776,特异度为0.773。NLR/CEA、NLR/CYFRA21-1间存在正相关关系(P<0.05),其余无统计学意义(P>0.05)。结论CEA、CYFRA21-1、Ferr、NLR水平在直肠良、恶性肿瘤间存在差异,4者联合检测对直肠癌早期诊断具有一定临床价值。Objective To explore the differences in tumor markers and Neutrophil to lymphocyte ratio(NLR)between benign and malignant rectal tumors,and to identify indicators that are meaningful for the early diagnosis of rectal cancer.Methods 126 patients with rectal cancer and 92 patients with benign rectal tumors were selected.Relevanted tumor markers Carcinoembryonic antigen(CEA),Cytokerantin-fragment-19(CYFRA21-1),Ferritin(Ferr),Carbohydrate antigen199(CA199),Carbohydrate antigen724(CA724)levels,and preoperative NLR levels.Analyzed the differences of each index between the two groups,and established binary Logistic regression models for the indexes with differences,and plotted the Receiver Operating Characteristic(ROC)curves,and performed correlation analysis of each index.Results The levels of age,CEA,CYFRA21-1 and NLR of patients in malignant group were higher than those in benign group,and the level of Ferr of patients in malignant group was lower than that in benign group,with statistical significance(P<0.05).CEA,CYFRA21-1 and NLR were risk factors for rectal cancer,and the Odds Ratio(OR)were 1.255(95%CI:1.088~1.446,P=0.002),1.602(95%CI:1.143~2.245,P=0.006)and 1.739(95%CI:1.003~3.015,P=0.049),respectively.Ferr was a protective factor for rectal cancer,and the OR value was 0.996(95%CI:0.993~0.998,P=0.001).The predictive probabilities of CEA,CYFRA21-1,Ferr and NLR for rectal cancer were 74.1%,69.2%,72.7%,65.0%,respec-tively.The prediction probability of the combination of the four was 83.7%.The sensitivity and specificity of com-bined detection of four markers were 0.776 and 0.773,respectively.There was a positive correlation between NLR/CEA and NLR/CYFRA21-1(P<0.05),and the rest were not statistically significant(P>0.05).Conclusion There are differences in the levels of CEA,CYFRA21-1,Ferr and NLR between benign and malignant rectal tumors.The combined detection of the four had some clinical value for the early diagnosis of rectal cancer.

关 键 词：直肠癌 癌胚抗原 细胞角质素片段19 铁蛋白 中性粒细胞/淋巴细胞 

分 类 号：R735.37[医药卫生—肿瘤]