摘要
目的:分析粪便隐血试验与糖类抗原19-9(CA19-9)、热休克蛋白α(HSP90α)、皮离蛋白(DCD)联合检测在大肠癌诊断中的价值。方法:选择我院2020年1月至2022年1月诊治大肠癌患者100例,将其纳入观察组。另选择同期体检疑似大肠癌但经病理证实为健康受试者81名,将其纳入对照组。检测血清CA19-9、HSP90α水平及DCD表达量,行粪便隐血试验。结果:观察组患者粪便隐血试验阳性78例,阳性率为78.0%;对照组患者阳性17例,阳性率为21.0%。观察组阳性率高于对照组(P<0.05)。观察组患者血清CA19-9、HSP90α水平均高于对照组(P<0.05),DCD表达量高于对照组(P<0.05)。血清CA19-9诊断大肠癌灵敏度为76.0%,特异度为86.4%,准确率为80.7%,临界值42.36U/mL,阳性预测值为87.4%,阴性预测值为74.5%,Kappa值为0.615;血清HSP90α诊断大肠癌灵敏度为79.0%,特异度为90.1%,准确率为84.0%,临界值71.59ng/mL,阳性预测值为90.8%,阴性预测值为77.7%,Kappa值为0.681;DCD诊断大肠癌灵敏度为80.0%,特异度为79.0%,准确率为83.8%,临界值9.72ng/mL,阳性预测值为87.9%,阴性预测值为79.5%,Kappa值为0.657;粪便隐血试验诊断大肠癌灵敏度为78.0%,特异度为81.2%,准确率为72.6%,阳性预测值为80.4%,阴性预测值为79.6%,Kappa值为0.601;四项联合诊断大肠癌灵敏度为83.0%,特异度为93.8%,准确率为87.8%,阳性预测值为94.3%,阴性预测值为81.7%,Kappa值为0.758;联合诊断的敏感性、特异性、准确率、阳性预测值及Kappa值最高。结论:粪便隐血试验联合检测血清CA19-9、HSP90α水平及DCD表达量能提升诊断大肠癌的准确性、特异性及敏感性,具有一定的临床价值。
Objective To investigate the value of stool occult blood test(SOBT)as well as the combined detection of CA19-9,HSP90αand DCD in the diagnosing large intestinal cancer.Methods Enrolled 100 patients with large intestinal cancer treated in author’s hospital(2020-01-2022-01)into observation group,and at the same time another 81 persons suspected as large intestinal cancer but pathological exam.confirmed as health were enrolled into control group,and with the 100 patients all received SOBT,as well as the combined detection of the levels of CA19-9 and HSP 90α,the expression volume of DCD.Results In SOBT positivity rate observation group was significantly higher than control group[78.0%(78/100)vs 21.0%(17/81),P<0.05],in the levels of CA19-9 and HSP90α,and DCD expression volume observation group was all higher than control group(P<0.05).In sensitivity,specificity,accurate rate,critical value,positive prognostic value,negative prognostic value,and Kappavalue,1)CA19-9:respectively,76.0%,86.4%,80.7%,42.36U/mL,87.4%,74.5%,and 0.615;2)HSP90α:79.0%,90.1%,84.0%,71.59ng/mL,90.8%,77.7%,and 0.681;3)DCD:80.0%,79.0%,83.8%,9.72ng/mL,87.9%,79.5%,and 0.657;4)SOBT:78.0%,81.2%,72.6%,no-critical value,80.4%,79.6%,and 0.601;5)the combiend detection of above four items:83.0%,93.8%,87.8%,no-critical value,94.3%,81.7%,and 0.758.Compared above detections in sensitivity,specificity,accurate rate,and positive prognostic value and Kappavalue,shown SOBT was the most.Conclusion SOBT combined with CA19-9,HSP90αlevels,as well as DCD expression volume can enhance the accurate rate,specificity,and sensitivity in the diagnosis of large intestinal cancer,thus,it has certain clinical value.
作者
夏铭阳
李帅
XIA Ming-yang;LI Shuai(Dept.of Medical Laboratory,the First People's Hospital of Shangqiu City,Shangqiu,Henan 476100)
出处
《中国肛肠病杂志》
2022年第10期1-3,共3页
Chinese Journal of Coloproctology
作者简介
第一作者:夏铭阳,男,河南商丘人,检验师,研究方向:检验科。E-mail:xmy940977827@163.com
