| 屈振杰,崔 琴,陈 吉,崔 宏,高美丽.血清CEA、CA19-9、CYFRA21-1与结直肠腺癌的相关性分析[J].,2021,(4):688-693 |
| 血清CEA、CA19-9、CYFRA21-1与结直肠腺癌的相关性分析 |
| Correlation Analysis of Serum CEA, CA19-9, CYFRA21-1 and Colorectal Adenocarcinoma |
| 投稿时间：2020-08-05 修订日期：2020-08-30 |
| DOI：10.13241/j.cnki.pmb.2021.04.018 |
| 中文关键词: CEA CA19-9 CYFRA21-1 结直肠腺癌 相关性分析 |
| 英文关键词: CEA CA19-9 CYFRA21-1 Colorectal adenocarcinoma Correlation analysis |
| 基金项目:内蒙古自治区自然科学基金项目（2017MS0879） |
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| 中文摘要: |
| 摘要 目的：探究血清癌胚抗原（carcinoembryonic antigen，CEA）、糖类抗原19-9、细胞角蛋白19 片段（cytokeratin19 fragements，CYFRA21-1）与结直肠腺癌的病理相关性。方法：选择于我院接受治疗的80例结直肠腺癌患者为病例组，选择同期于我院接受治疗的50例良性结直肠病变患者为良性对照组，选择我院体格检查的50例健康个体为对照组，分别采集三组个体的血样并进行CEA、CA19-9以及CYFRA21-1水平的检测，并比对三组个体上述因子阳性表达率、因子水平，同时分析三种因子同结直肠腺癌患者TNM分期相关性，最后探究三种因子对结直肠腺癌的诊断价值。结果：（1）以CEA≥2.805 μg/L、CA19-9≥39 U/mL、CYFR21-1≥3.3 ng/mL为临界值，结果显示病例组CEA阳性率51.25 %，CA19-9阳性率31.25 %，CYFR21-1阳性率40.00 %，明显高于良性组的10.00 %、20.00 %和10.00 %，高于对照组的8.00 %、12.00 %和2.00 %（P<0.05）；（2）比较显示病例组患者的CEA、CA19-9以及CYFR21-1水平明显高于良性对照组以及对照组（P<0.05），良性对照组CEA、CA19-9以及CYFR21-1水平明显高于对照组（P<0.05）；（3）比较显示IV期结直肠腺癌患者CEA、CA19-9以及CYFRA21-1水平明显高于III期以及I+II期（P<0.05），III期三种因子水平明显高于I+II期（P<0.05）；（4）CEA对结直肠腺癌诊断一致性71.25 %，灵敏度65.00 %，特异度90.00 %；CA19-9诊断一致性46.25 %，灵敏度35.00 %，特异度80.00 %；CYFRA21-1诊断一致性55.00 %，灵敏度46.67 %，特异度80.00 %；联合诊断一致性95.00 %，灵敏度95.00 %，特异度95.00 %。结论：血清CEA、CA19-9以及CYFRA21-1对结直肠腺癌具有较明确的诊断价值，不同病理分期患者中表达差异明显，可以考虑将联合诊断作为结直肠腺癌鉴别方式之一，推广于临床中。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the pathological correlation between serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9, cytokeratin 19 fragements (CYFRA21-1) and colorectal adenocarcinoma. Methods: A total of 80 patients with colorectal adenocarcinoma, who were treated in Third Affiliated Hospital of Inner Mongolia Medical University, were chosen as case group; during the same period, 50 patients with benign colorectal disease were chosen as benign control group, and 50 healthy individuals with physical examination in the hospital were chosen as control group. The blood samples of three groups of individuals were collected and the levels of CEA, CA19-9 and CYFRA21-1 were tested. The positive expression rates and factor levels of the above factors were compared among the three groups. The correlation of the three factors with TNM staging of cancer patients was analysed, and finally the diagnostic value of three factors for colorectal adenocarcinoma was explored. Results: (1) With CEA≥2.805 μg/L, CA19-9≥39 U/mL, CYFR21-1≥3.3 ng/ml as the critical values, the results showed that the CEA positive rate in the case group was 51.25 %, and the CA19-9 positive rate was 31.25 %, the positive rate of CYFR21-1 was 40.00 %, significantly higher than that in the benign group (10.00 %, 20.00 %, and 10.00 %), and higher than that in the control group (8.00 %, 12.00 %, and 2.00 %, P<0.05). (2) The CEA, CA19-9 and CYFR21-1 levels in the case group were significantly higher than those in the benign control group and the control group (P<0.05), and the CEA, CA19-9 and CYFR21-1 levels in the benign control group were significantly higher than those in the control group (P<0.05). (3) The levels of CEA, CA19-9 and CYFRA21-1 in the patients with stage IV colorectal adenocarcinoma were significantly higher than those in stage III and stage I and II (P<0.05), and the levels of three factors in stage III were significantly higher than those in stage I and II (P<0.05）. (4) The diagnostic consistency of CEA for colorectal adenocarcinoma was 71.25 %, sensitivity 65.00 %, specificity 90.00 %; CA19-9 diagnosis consistency was 46.25 %, sensitivity 35.00 %, specificity 80.00 %; CYFRA21-1 diagnostic consistency 55.00 %, sensitivity 46.67 %, specificity 80.00 %; joint diagnosis consistency 95.00 %, sensitivity 95.00 %, specificity 95.00 %. Conclusion: Serum CEA, CA19-9 and CYFRA21-1 have a clear diagnostic value for colorectal adenocarcinoma. The expression difference in patients with different pathological stages is obvious. It can be considered to use combined diagnosis as one of the methods of colorectal adenocarcinoma differentiation in the clinical application. |
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