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目的观察结直肠癌(CRC)患者血清博新肿瘤相关物质(Bo Xin tumor marker,BXTM)水平,探讨其在CRC诊断中的价值。方法以2012年6月至2013年6月155例CRC、32例结直肠腺瘤、34例结直肠息肉患者和120例体检健康者为研究对象,检测研究对象血清中BXTM和癌胚抗原(CEA)水平并进行分析。对30例成功接受CRC根治术患者手术前及手术1、3、7、10 d后血清BXTM和CEA水平进行监测,BXTM>95 U/mL、CEA>5 ng/mL为阳性。结果 CRC组血清BXTM水平(106.1±10.2)U/mL和CEA水平(11.9±9.8)ng/mL高于结直肠腺瘤组、息肉组和健康人群(P均<0.05),CRC组血清BXTM阳性率(74.8%)和CEA阳性率(47.1%)高于结直肠腺瘤组、息肉组和健康人群(P均<0.05)。Ⅲ期和Ⅳ期CRC患者血清BXTM水平和阳性率高于Ⅰ期和Ⅱ期(t=4.876,χ2=9.418,P均<0.05),年龄、性别、肿瘤部位对血清BXTM测定结果无影响(P均>0.05)。手术治疗后7 d和10 d血清BXTM水平下降(P均<0.05),CEA水平变化无统计学意义(P>0.05)。血清BXTM水平和CEA水平呈正相关(r=0.534,P<0.05),血清BXTM诊断CRC及腺瘤的ROC曲线下面积为0.881,高于CEA的0.804(Z=3.076,P<0.05),两者联合检测诊断CRC的敏感性(85.2%)高于BXTM(74.8%)和CEA(47.1%)单独检测,P均<0.05。结论 BXTM水平在CRC患者血清中明显升高,可为CRC的筛查和动态监测提供一定依据,有望用于CRC辅助诊断。
Objective To observe the level of serum BXTM in patients with colorectal cancer (CRC) and to explore its value in the diagnosis of CRC. Methods 155 cases of CRC, 32 cases of colorectal adenoma, 34 cases of colorectal polyps from June 2012 to June 2013 and 120 healthy subjects were included in this study. Serum levels of BXTM and carcinoembryonic antigen (CEA ) Level and analyzed. Serum levels of BXTM and CEA were measured in 30 patients who underwent radical operation and 1,3,7 and 10 days after surgery. BXTM> 95 U / mL and CEA> 5 ng / mL were positive. Results The levels of serum BXTM in CRC group (106.1 ± 10.2) U / mL and CEA level (11.9 ± 9.8) ng / mL were higher than those in colorectal adenoma group, polyp group and healthy group (all P <0.05) (74.8%) and CEA positive rate (47.1%) were higher than those in colorectal adenoma group, polyp group and healthy population (all P <0.05). The serum level of BXTM and the positive rate of stage Ⅲ and stage Ⅳ CRC patients were higher than those of stage Ⅰ and Ⅱ (t = 4.876, χ2 = 9.418, P <0.05 respectively). The age, sex and tumor location had no effect on the serum BXTM All> 0.05). Serum BXTM levels decreased on the 7th and 10th postoperatively (all P <0.05), but CEA level had no significant difference (P> 0.05). Serum BXTM level was positively correlated with CEA level (r = 0.534, P <0.05). The area under ROC curve of serum BXTM in diagnosis of CRC and adenoma was 0.881, higher than that of CEA 0.804 (Z = 3.076, P <0.05) The sensitivity of combined detection of CRC diagnosis (85.2%) was higher than that of BXTM (74.8%) and CEA alone (47.1%), P <0.05. Conclusion The level of BXTM is significantly elevated in the serum of patients with CRC, which may provide a basis for the screening and dynamic monitoring of CRC. It is expected to be used in the diagnosis of CRC.