肿瘤标志物联合25羟基维生素D诊断结直肠癌的价值

目的:研究肿瘤标志物联合25羟基维生素D［25(OH)D］诊断结直肠癌的价值。方法:选取2017年9月至2018年2月在我院就诊的结直肠癌患者73例作为结直肠癌组，随机选取同期在我院健康体检的70例作为对照组，对比两组血清CEA、CA125、CA19-9和25(OH)D水平，分析结直肠癌患者病理特征与血清25(OH)D水平的关系；计算肿瘤标志物、25(OH)D单独或联合检测诊断结直肠癌的灵敏度、特异度和准确度；探讨血清25(OH)D水平与肿瘤标志物间的关系。结果:结直肠癌组的血清CEA、CA125、CA19-9水平显著高于对照组（P＜0.05），25(OH)D水平显著低于对照组（P＜0.05）。不同性别、年龄、发病部位、细胞分化、临床分期、淋巴结转移结直肠癌患者的血清25(OH)D水平差异有统计学意义（P＜0.05）。血清25(OH)D检测对结直肠癌诊断的临界值为14.26 nmol/L，灵敏度为53.80%，特异度为66.72%，曲线下面积（AUC）为0.666（0.625～0.705）。血清肿瘤标志物联合25(OH)D检测的诊断灵敏度、特异度和准确度最大，分别为78.51%、83.83%、86.25%。血清25(OH)D高水平组CEA、CA125和CA19-9水平显著低于低水平组（P＜0.05）。结论:肿瘤标志物联合25(OH)D检测对于结直肠癌诊断具有重要意义。

The value of tumor markers combined with 25-hydroxyvitamin D in the diagnosis of colorectal cancer

Objective:To study the value of tumor markers combined with 25-hydroxyvitamin D［25(OH)D］ in the diagnosis of colorectal cancer.Methods:Seventy-three patients with colorectal cancer who were treated in our hospital from September 2017 to February 2018 were selected as the colorectal cancer group.70 cases in our hospital for physical examination were randomly selected as the control group.The serum level of CEA,CA125,CA19-9 and 25(OH)D between the two groups was compared,and the relationship between pathological features of patients with colorectal cancer and serum 25(OH)D levels was analysed.Sensitivity,specificity and accuracy of tumor markers,25(OH)D alone or in combination for the diagnosis of colorectal cancer were calculated.The relationship between serum 25(OH)D levels and tumor markers was explored.Results:The levels of CEA,CA125 and CA19-9 in the colorectal cancer group were significantly higher than those of the control group,25(OH)D in the colorectal cancer group were significantly lower than the control group（P＜0.05).There were significantly differences of serum 25(OH)D levels in patients with different genders,age,location,cell differentiation,clinical stage and lymph node metastasis（P＜0.05).The detection of serum 25(OH)D for colorectal cancer had a critical value of 14.26 nmol/L,sensitivity of 53.80%,specificity of 66.72%,and area under the curve（AUC) of 0.666（0.625~0.705).The diagnostic sensitivity,specificity and accuracy of serum tumor markers combined with 25(OH)D were the highest,which were 78.51%,83.83% and 86.25%,respectively.The levels of CEA,CA125 and CA19-9 in the serum 25(OH)D high level group were significantly lower than those in the low level group（P＜0.05).Conclusion:The combination of tumor markers and 25(OH)D is important for the diagnosis of colorectal cancer.