结直肠癌与胃癌血清微量元素表达差异及鉴别诊断价值

Differential Expression of Serum Trace Elements between Colorectal Cancer and Gastric Cancer and Its Differential Diagnostic Value

摘要: 目的：探讨血清中五种微量元素(钙、铁、锌、铜、镁)在结直肠癌(CRC)与胃癌(GC)患者中的特征性表达差异，并分析其在两种恶性肿瘤鉴别诊断中的临床参考价值。方法：采用回顾性研究方法，收集2024年本院收治的50例结直肠癌患者(CRC组)与50例胃癌患者(GC组)的临床资料。对比两组患者初诊时的基线资料及血清5种微量元素(Ca, Fe, Zn, Cu, Mg)水平。运用Mann-Whitney U检验分析组间表达差异，并通过受试者工作特征(ROC)曲线评估具有显著差异的微量元素指标对CRC与GC的鉴别诊断效能。结果：两组患者在年龄(P = 0.230)和性别(P = 0.183)等基线资料对比中，差异均无统计学意义，具有可比性。血清检验结果显示，CRC组患者的血清铁(Fe)水平显著低于GC组，差异具有统计学意义(P = 0.016)；而两组间的铜(Cu)、锌(Zn)、钙(Ca)及镁(Mg)水平比较，差异均无统计学意义(均P > 0.05)。ROC曲线分析证实，血清Fe检测鉴别CRC与GC的曲线下面积(AUC)为0.639，当最佳截断值为18.026时，其对应的敏感度为38.5%，特异度为94.0%。结论：CRC与GC患者在血清微量元素代谢上存在局部异质性，其中CRC患者的血清Fe水平显著偏低。血清Fe指标对于临床辅助鉴别CRC与GC具有一定的潜在诊断参考价值，尤其具备较高的鉴别特异度，可作为无创辅助检验的补充指标。

Abstract: Objective: To investigate the characteristic expression differences of five trace elements (calcium, iron, zinc, copper and magnesium) in serum between patients with colorectal cancer (CRC) and gastric cancer (GC), and to analyze their clinical reference value in differential diagnosis of two kinds of malignant tumors. Methods: The clinical data of 50 patients with colorectal cancer (CRC group) and 50 patients with gastric cancer (GC group) admitted to our hospital in 2024 were collected by retrospective study. The baseline data and serum levels of five trace elements (Ca, Fe, Zn, Cu, Mg) were compared between the two groups. Mann-Whitney U test was used to analyze the difference of expression between groups, and the differential diagnostic efficacy of trace element indexes with significant differences between CRC and GC was evaluated by receiver’s operating characteristics (ROC) curve. Results: There was no significant difference between the two groups in baseline data such as age (P = 0.230) and gender (P = 0.183), which was comparable. The results of serum test showed that the serum iron (Fe) level in CRC group was significantly lower than that in GC group, and the difference was statistically significant (P = 0.016). However, there was no significant difference in the levels of copper (Cu), zinc (Zn), calcium (Ca) and magnesium (Mg) between the two groups (all P > 0.05). ROC curve analysis confirmed that the area under the curve (AUC) of serum Fe detection in differentiating CRC from GC was 0.639. When the optimal cutoff value was 18.026, its corresponding sensitivity was 38.5% and specificity was 94.0%. Conclusion: There are local heterogeneity in serum trace element metabolism between CRC and GC patients, and the serum Fe level of CRC patients is significantly lower. Serum Fe index has certain potential diagnostic reference value for clinical auxiliary differential diagnosis of CRC and GC, especially with high differential specificity, and can be used as a supplementary index for noninvasive auxiliary test.