论文部分内容阅读
目的探讨联合检测血清肿瘤标志物在结直肠癌诊断和预后判断中的应用,为结直肠癌的早期诊断以及预后的判断提供依据。方法天水四〇七医院2010年3月至2012年6月收治的70例结直肠癌患者作为观察组,另选取70例健康体检者为健康对照组,观察两组多项肿瘤标志物,如癌胚抗原(CEA)、癌相关糖抗原(CA19-9、CA72-4)及细胞角蛋白19的可溶性片段(CYFRA21-1)等检测情况。结果 70例结直肠癌患者术前CEA、CA19-9、CA72-4和CYFRA21-1的水平分别为(29.7±16.3)、(53.1±18.9)、(17.2±18.8)和(14.8±10.2)ng/mL,显著高于健康对照组,差异具有统计学意义(P<0.05)。观察组肿瘤标志物检测阳性率分别为31.4%、12.9%、10.0%和12.9%,而联合检测阳性率为48.5%,联合检测可明显提高诊断的敏感度,与单个指标检测相比,差异具有统计学意义(P<0.05)。TNMⅡ、Ⅲ期患者4项肿瘤标志物均明显高于TNMⅠ期患者,差异具有统计学意义(P<0.05)。术后1年随访检测4项指标均有下降。然而肿瘤复发和转移时,CEA、CA19-9、CA72-4和CYFRA21-1再度明显升高。结论联合检测血清肿瘤标志物CEA、CA19-9、CA72-4和CYFRA21-1可提高结直肠癌诊断率,有助于结直肠癌的早期诊断,可用于判断结直肠癌预后。
Objective To explore the application of combined detection of serum tumor markers in the diagnosis and prognosis of colorectal cancer and provide evidence for the early diagnosis and prognosis of colorectal cancer. Methods Seventy patients with colorectal cancer who were treated in Tianshui 407 Hospital from March 2010 to June 2012 were selected as the observation group. Another 70 healthy people were selected as the healthy control group. Two groups of tumor markers such as cancer Embryo antigen (CEA), cancer-associated carbohydrate antigen (CA19-9, CA72-4) and cytokeratin 19 soluble fragment (CYFRA21-1). Results The preoperative levels of CEA, CA19-9, CA72-4 and CYFRA21-1 in 70 patients with colorectal cancer were (29.7 ± 16.3), (53.1 ± 18.9), (17.2 ± 18.8) and (14.8 ± 10.2) ng / mL, significantly higher than the healthy control group, the difference was statistically significant (P <0.05). The positive rates of tumor markers in the observation group were 31.4%, 12.9%, 10.0% and 12.9%, respectively, while the positive rate of combined detection was 48.5%. The combined detection could significantly improve the diagnostic sensitivity. Compared with the single index test, the difference was Statistical significance (P <0.05). Four tumor markers in patients with TNMⅡ and Ⅲ were significantly higher than those in TNMⅠstage, the difference was statistically significant (P <0.05). Follow-up 1-year follow-up detection of four indicators have decreased. However, tumor recurrence and metastasis, CEA, CA19-9, CA72-4 and CYFRA21-1 again significantly increased. Conclusion Combined detection of serum tumor markers CEA, CA19-9, CA72-4 and CYFRA21-1 can improve the diagnostic rate of colorectal cancer, contribute to the early diagnosis of colorectal cancer and can be used to determine the prognosis of colorectal cancer.