基于C反应蛋白新炎症因子组合在结直肠癌诊断中的临床价值

Clinical Value of Novel Inflammatory Factor Combinations Based on C-Reactive Protein in the Diagnosis of Colorectal Cancer

摘要: 目的：探讨基于C反应蛋白为基础的新炎症因子组合LCR、CAR及CA199、CEA等指标在结直肠癌临床诊断中的价值。方法：将2020年04月至2023年04月在本院手术治疗的结直肠癌患者163例设置为结直肠癌组，93例结直肠息肉组为对照组。通过比较淋巴细胞/C反应蛋白比值(LCR)、C反应蛋白/白蛋白比值(CAR)，CA199及CEA在两组中的差异，与临床病理特征关联分析，ROC曲线绘制检测结果。结果：结直肠癌组中CAR、CEA、CA199表达明显增高，LCR表达下降，各组存在统计学差异(P < 0.001)。LCR在肿瘤浸润深度(T3 + T4)组表达明显低于(T1 + T2)组，有淋巴结转移组表达降低，TNM分期为(III + IV)表达明显低于(I + II)组，各组之间均有统计学差异。而CAR、CEA、CA199表达与LCR相反，各组统计学差异明显(P < 0.05)。ROC提示联合诊断敏感度为56.4%，特异性为90.3%。结论：LCR、CAR、CA199、CEA水平与结直肠癌患者的临床病理特征相关，对结直肠癌的诊断有潜在价值，联合检测能提高对结直肠癌诊断的特异度。

Abstract: Objective: Exploring the value of new inflammatory factor combinations based on C-reactive protein, such as LCR, CAR, CA199, CEA in the clinical diagnosis of colorectal cancer. Methods: A total of 163 patients with colorectal cancer who received surgical treatment in our hospital from April 2020 to April 2023 were selected as the colorectal cancer group and 93patients with colorectal polyp group as the control group. By comparing the differences of lymphocyte/C-reactive protein ratio (LCR), C-reactive protein/albumin ratio (CAR), CA199 and CEA in the two groups, correlation analysis was performed with clinicopathological features, and the detection efficiency results were plotted by ROC curve. Results: The expressions of CAR, CEA and CA199 were significantly increased in colorectal cancer group, while the expressions of LCR were decreased, with statistical differences among all groups (P < 0.001). The expression of LCR in the depth of tumor invasion (T3 + T4) group was significantly lower than that in the (T1 + T2) group, the expression of LCR was decreased in the group with lymph node metastasis, and the expression of TNM staging (III + IV) was significantly lower than that in the (I + II) group, with statistical differences among all groups. The expressions of CAR, CEA and CA199 were opposite to those of LCR, and there were statistical differences among all groups (P < 0.05). The ROC curve indicated that the sensitivity and specificity of combined diagnosis were 55.2% and 90.3%. Conclusions: The levels of LCR, CAR, CA199 and CEA are correlated with the clinicopathologic characteristics of patients with colorectal cancer, and have potential value in the diagnosis of colorectal cancer. Combined detection can improve the sensitivity of the diagnosis of colorectal cancer.