| 陈志林,徐秋贞,陈文龙,邵海磊,童天夫,杜 阳,王 皓.CT增强在结肠癌分期中的应用及联合血清CEA、CA199、 CA724及microRNA-21对良恶性病变的诊断价值[J].,2023,(20):3923-3928 |
| CT增强在结肠癌分期中的应用及联合血清CEA、CA199、 CA724及microRNA-21对良恶性病变的诊断价值 |
| Application of CT Enhancement in the Staging of Colon Cancer and the Diagnostic Value of Combined Serum CEA, CA199, CA724 and microRNA-21 in Benign and Malignant Lesions |
| 投稿时间：2023-02-09 修订日期：2023-03-04 |
| DOI：10.13241/j.cnki.pmb.2023.20.025 |
| 中文关键词: CT增强 CEA CA199 CA724 microRNA-21 结肠癌 分期 良恶性病变 |
| 英文关键词: CT enhancement CEA CA199 CA724 MicroRNA-21 Colon cancer Staging Benign and malignant lesions |
| 基金项目:江苏省卫生健康委医学科研项目（MSXM2021154） |
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| 中文摘要: |
| 摘要 目的：探讨CT增强在结肠癌分期中的应用及联合血清CEA、CA199、 CA724及microRNA-21对良恶性病变的诊断价值。方法：将我院2018年3月至2022年3月确诊的85例结肠癌患者纳入观察组，选取同期85例结肠良性肿瘤患者纳入对照组。以病理结果为金标准，分析CT增强分期对结肠癌患者T、N、M分期的诊断价值，并比较两组的血清CEA、CA199、 CA724、microRNA-21水平，同时评估CT增强及血清CEA、CA199、CA724、microRNA-21单独及联合诊断结肠癌良恶性病变价值。结果：CT增强T分期准确率为88.2%，一致性较高（Kappa值=0.812）；CT增强N分期准确率为63.5% ，一致性一般（Kappa值=0.449）；CT增强M分期准确率为90.6%，一致性较高（Kappa值=0.739）。观察组血清CEA、CA199、CA724、microRNA-21水平均高于对照组（P<0.05）。受试者工作特征曲线（ROC）分析结果显示：CT增强及血清CEA、CA199、CA724、microRNA-21单独及联合诊断结肠癌良恶性病变的ROC曲线下的面积（AUC）（0.95CI）分别为0.783、0.722（0.497～0.944）、0.694（0.475～0.916）、0.704（0.434～0.977）、0.687（0.393～0.967）、0.917（0.829～0.982）。CT增强及联合血清CEA、CA199、CA724、microRNA-21检查恶性结肠癌患者75例，诊断灵敏度88.2%，特异性90.6%，准确性89.4%。结论：CT增强可以应用于结肠癌分期，并且CT增强结合血清CEA、CA199、CA724及microRNA-21可以有效、准确地判断结肠癌的良恶性病变情况，对提高结肠癌的诊断具有重要临床意义。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the application of CT enhancement in the staging of colon cancer and the diagnostic value of combined serum CEA, CA199, CA724 and microRNA-21 in benign and malignant lesions. Methods: 85 patients with colon cancer diagnosed in our hospital from March 2018 to March 2022 were included in the observation group, and 85 patients with colon benign tumors in the same period were included in the control group.Based on the pathological results as the gold standard, the diagnostic value of CT enhanced staging in T, N, M staging of colon cancer patients was analyzed,and compared the serum CEA, CA199, CA724,microRNA-21 levels between the two groups. At the same time, evaluated the value of CT enhancement and serum CEA, CA199, CA724, microRNA-21 alone and joint in the diagnosis of benign and malignant lesions of colon cancer. Results: The accuracy of CT enhanced T staging was 88.2%, with high consistency (Kappa value=0.812); The accuracy rate of CT enhanced N staging was 63.5%, with general consistency (Kappa value=0.449); The accuracy rate of CT enhanced M staging was 90.6%, with high consistency (Kappa value=0.739). The levels of serum CEA, CA199, CA724 and microRNA-21 in the observation group were higher than those in the control group(P<0.05). The analysis results of the receiver operation characteristic curve(ROC) of the subjects showed that the area under the ROC curve (AUC) (0.95CI) of CT enhancement and serum CEA, CA199, CA724 and microRNA-21 in the diagnosis of benign and malignant lesions of colon cancer were 0.783, 0.722 (0.497～0.944), 0.694 (0.475～0.916), 0.704 (0.434～0.977), 0.687 (0.393～0.967) and 0.917 (0.829～0.982), respectively. 75 patients with malignant colon cancer were examined by CT enhancement and joint with serum CEA, CA199, CA724 and microRNA-21. The diagnostic sensitivity was 88.2%, specificity was 90.6%, and accuracy was 89.4%. Conclusion: CT enhancement can be applied to the staging of colon cancer,and the joint of CT enhancement with serum CEA, CA199,CA724 and microRNA-21 can effectively and accurately determine the benign and malignant lesions of colon cancer, which has important clinical significance in improving the diagnosis of colon cancer. |
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