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[目的]探讨结直肠癌患者C反应蛋白(CRP)和血清淀粉样蛋白A(SAA)对结直肠癌术前诊断的价值。[方法]纳入140例结直肠癌患者于术前3d测定血清CRP和SAA的水平,分析CRP和SAA术前水平与术后病理分期的关系。[结果]CRP和SAA在结直肠癌不同的肿瘤部位、分化程度和手术方案间的差异有统计学意义(P<0.05)。CRP和SAA在结直肠癌不同的TNM分期、N分期和M分期间差异也有统计学意义(P<0.005)。建立诊断Ⅱ~Ⅳ期结直肠癌的ROC曲线,SAA的曲线下面积AZ=0.673(P=0.003),取SAA诊断Ⅱ~Ⅳ期结直肠癌的分界点为2.700mg/L,准确度为69.9%,敏感度为72.3%,特异度为54.5%。建立诊断淋巴结转移结直肠癌的ROC曲线,SAA的ROC曲线下面积AZ=0.631(P=0.013),取SAA诊断淋巴结转移结直肠癌的分界点为3.295mg/L,准确度为61.0%,敏感度为70.0%,特异度为51.9%。[结论]CRP和SAA与结直肠癌分期相关,SAA在筛选Ⅱ~Ⅳ期需要接受新辅助治疗的结直肠癌患者以及评估是否有淋巴结转移上具有潜在的临床应用价值。
[Objective] To investigate the value of C-reactive protein (CRP) and serum amyloid A (SAA) in preoperative diagnosis of colorectal cancer. [Methods] The serum levels of CRP and SAA in 140 patients with colorectal cancer were measured before operation, and the relationship between preoperative levels of CRP and SAA and pathological stage was analyzed. [Results] There were significant differences in the degree of differentiation between CRP and SAA in different tumor sites of colorectal cancer and surgical plans (P <0.05). CRP and SAA in colorectal cancer in different TNM staging, N stage and M stage difference was also statistically significant (P <0.005). The ROC curves of diagnosing stage Ⅱ ~ Ⅳ colorectal cancer were established. The area under the curve of SAA was AZ = 0.673 (P = 0.003). The cut-off point of diagnosing stage Ⅱ ~ Ⅳ colorectal cancer with SAA was 2.700mg / L with an accuracy of 69.9 %, Sensitivity was 72.3%, specificity was 54.5%. To establish a ROC curve for the diagnosis of lymph node metastatic colorectal cancer, the area under the ROC curve of SAA was 0.631 (P = 0.013). The cut-off point of SAA for diagnosing lymph node metastasis was 3.295mg / L with accuracy of 61.0% Degree was 70.0%, specificity was 51.9%. [Conclusion] CRP and SAA are associated with staging of colorectal cancer. SAA has potential clinical value in screening patients with colorectal cancer who require neoadjuvant therapy for stage Ⅱ ~ Ⅳ and for assessing whether there is lymph node metastasis.