粪便革兰染色在结直肠腺瘤中的诊断价值  

Diagnostic value of fecal Gram staining for colorectal adenoma

作　　者：高洁 刘蕾 林雯 柯玲玲 金文平 孙建斌 GAO Jie;LIU Lei;LIN Wen;KE Lingling;JIN Wenping;SUN Jianbin(Department of Clinical Laboratory,Wuhan Third Hospital,Wuhan,Hubei 430000,China)

机构地区：[1]武汉市第三医院检验科,湖北430000

出　　处：《中国微生态学杂志》2025年第3期312-317,共6页Chinese Journal of Microecology

摘　　要：目的 分析结直肠腺瘤(CRA)患者粪便革兰染色特征,并探讨其在CRA中的诊断价值。方法 选取2021年1月至2021年12月武汉市第三医院收治的40例有结直肠腺瘤性息肉的患者作为研究组(CRA组),选取同期收治的52例有结直肠炎性或增生性息肉的患者作为对照组(Non-CRA组)。比较两组患者临床资料以及粪便革兰染色情况、粪便免疫化学检测(FIT)情况、血清癌胚抗原(CEA)水平,并分析这三项指标单独检测及联合检测的灵敏度、特异度和准确度。结果 CRA组患者粪便革兰染色异常的发生率高于NonCRA组(P<0.05),其中CRA组细菌总数减少的发生率高于Non-CRA组(P<0.05)。粪便革兰染色诊断CRA的灵敏度、特异度、准确度分别为37.50%、82.69%、63.04%;FIT的灵敏度、特异度、准确度分别为10.00%、92.31%、56.52%;血清CEA的灵敏度、特异度、准确度分别为7.50%、96.15%、57.61%;三项指标联合检测的灵敏度、特异度、准确度分别为47.50%、71.15%、60.87%;其中,粪便革兰染色灵敏度显著高于FIT和血清CEA的灵敏度(均P<0.05)。结论 与FIT和血清CEA相比,粪便革兰染色可显著提高对CRA的诊断能力,可为CRA筛查提供新的思路。Objective To reveal the profile of fecal Gram staining in patients with colorectal adenoma(CRA) and explore its diagnostic value in CRA.Methods Forty patients with colorectal adenomatous polyps admitted to our hospital from January 2021 to December 2021 were selected as the observation group(CRA group) while 52 patients with colorectal inflammatory or hyperplastic polyps were selected as the control group(Non-CRA group).The characteristics of clinical data,fecal Gram staining,fecal immunochemical test(FIT) and serum carcinoembryonic antigen(CEA) levels were compared between the two groups.And the sensitivity,specificity and accuracy of the three indexes alone and in combination for diagnosis of CRA were analyzed.Results The incidence of abnormal fecal Gram staining in CRA group was higher than that in Non-CRA group(P<0.05).Particularly,decreased fecal bacterial counts occurred more frequently in CRA group(P<0.05).The sensitivity,specificity and accuracy of fecal Gram staining for the diagnosis of CRA were37.50%,82.69% and 63.04%,those of FIT were 10.00%,92.31% and 56.52%,those of serum CEA were 7.50%,96.15%and 57.61%,and those of the three indexes in combination were 47.50%,71.15% and 60.87%,respectively.The sensitivity of fecal Gram staining for the diagnosis of CRA was higher than that of FIT or serum CEA(all P<0.05).Conclusion Compared with FIT and serum CEA,fecal Gram staining can significantly improve the diagnostic ability for CRA,which may provide a new pathway for CRA screening.

关 键 词：结直肠腺瘤 结直肠癌 肠道菌群 粪便革兰染色 癌胚抗原 粪便免疫化学检测 

分 类 号：R446.5[医药卫生—诊断学]