血清多项肿瘤标志物联合检测在结直肠癌早期诊断中的价值

The Value of Combined Detection of Multiple Serum Tumor Markers in the Early Diagnosis of Colorectal Cancer

摘要: 目的：探讨血清肿瘤标志物癌胚抗原(CEA)、糖类抗原199 (CA199)、糖类抗原724 (CA724)联合检测在结直肠癌诊断中的价值。方法：选取2023年1月至2024年12月期间于北华大学附属医院首次诊治的结直肠癌患者50例作为观察组，另选取同期结直肠良性病变患者50例作为对照组。检测并比较两组患者血清CEA、CA199、CA724水平。由于数据呈偏态分布，以中位数(四分位数间距)描述，组间比较采用Mann-Whitney U检验。分析上述指标单独与联合检测对结直肠癌的诊断效能。结果：观察组血清CEA、CA199、CA724水平中位数均显著高于对照组。多因素Logistic回归分析显示，血清CEA、CA199、CA724水平升高均是发生结直肠癌的独立危险因素(均P < 0.05)，其中CA724的预测能力最强(OR = 1.24, 95% CI: 1.10~1.40)。联合检测的敏感度(91.11%)和AUC值(0.941)均显著高于任一单项检测。结论：血清CEA、CA199、CA724均可作为诊断结直肠癌的辅助生物学指标，三者联合检测可显著提高诊断敏感度，对结直肠癌高危人群的筛查具有一定意义。

Abstract: Objective: To evaluate the diagnostic value of the combined detection of serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and carbohydrate antigen 724 (CA724) in colorectal cancer (CRC). Methods: A total of 50 patients with initially diagnosed CRC at the Affiliated Hospital of Beihua University from January 2023 to December 2024 were enrolled as the observation group, along with 50 patients with benign colorectal lesions during the same period as the control group. Serum levels of CEA, CA199, and CA724 were measured and compared between the two groups. As the data were skewed, they were described using the median (interquartile range), and the Mann-Whitney U test was used for group comparisons. The diagnostic efficacy of individual and combined detection for CRC was analyzed. Results: The median levels of serum CEA, CA199, and CA724 in the observation group were significantly higher than those in the control group. Multivariate Logistic regression analysis identified elevated serum CEA, CA199, and CA724 as independent risk factors for CRC (all P < 0.05), with CA724 demonstrating the strongest predictive capability (OR = 1.24, 95% CI: 1.10~1.40). The combined detection showed significantly higher sensitivity (91.11%) and a larger area under the curve (AUC = 0.941) than any single marker alone. Conclusion: Serum CEA, CA199, and CA724 can serve as auxiliary biological indicators for diagnosing CRC. Their combined detection significantly improves diagnostic sensitivity and holds potential value for screening high-risk populations.