炎性介质CRP与SAA在结直肠癌术前分期的诊断价值

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）对结直肠癌术前分期的价值。方法纳入病理诊断为结直肠癌患者127例，所有患者于术前第3天测定血清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TNM分期、N分期和M分期之间的差异有统计学意义（Pd0．005）。SAA诊断Ⅱ～Ⅳ期结直肠癌的ROC曲线下面积A1=0．673（P=0．003），取2．700mg／L为分界点，诊断的准确度为69．9％，敏感度为72．3％，特异度为54．5％。SAA诊断淋巴结转移结直肠癌的ROC曲线下面积AZ=0．631（P=0．013），取3．295mg／L分界点，诊断的准确度为61．O％，敏感度为70．O％，特异度为51．9％。结论炎性介质CRP和SAA与结直肠癌分期的进展有关，SAA具有筛选Ⅱ～Ⅳ期需要接受新辅助治疗的患者以及评估是否有淋巴结转移的潜在价值。

The diagnostic value of inflammatory markers in preoperative staging of colorectal cancer

Objective To assess the application value of C-reactive protein （CRP） and serum amyloid A protein （SAA） in the preoperative staging of coloreetal cancer. Methods 127 patients pathologically proved colorectal cancer were recruited and measured by serum levels of CRP and SAA at 3rd day preoperatively. The data pool were analyzed comparing preoperative levels of CRP and SAA with postoperatively pathological staging. Results There were statistical- ly significant differences （P〈0.05） of both CRP and SAA in tumor localization, histological differentiation and operative procedures. Moreover, the significant differences were observed statistically of both CRP and SAA in TNM stage, N stage and M stage. Furthermore, contriving the ROC curve of CRP and SAA for colorectal cancer in stage II-IV, of which the area under curve of SAA was 0. 673 （P= 0. 003）. The accuracy, sensitivity and specificity were 69.9%, 72.3% and 54.5%, respectively, while the cutoff point was defined as 2. 700 mg/L. To diagnose the metastatic lymph nodes, the ROC curve of CRP and SAA were constructed, of which the area under curve of SAA was 0. 631 （P = 0. 013）, to analyze the accuracy, sensitivity and specificity were 61.0%, 70. 0% and 51.9% respectively, while the cut- off point was referred to 3. 295 mg/L. Conclusion The inflammatory markers, involving CRP and SAA, are related with advancement of co]orectal cancer. Moreover, the SAA is a potential biomarker to screen the colorectal cancer in stage Ⅱ～Ⅳ s required to undertake the neo-adjuvant therapy, or to assess the possibility of metastatic lymph nodes.