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血清癌胚抗原联合C-反应蛋白对根治性直肠癌造口患者术后感染的早期诊断价值 被引量:1

Diagnostic value of the combination of serum carcinoembryonic antigen and C-reactive protein in the early postoperative infection in patients after radical rectal cancer ostomy
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摘要 目的探讨血清癌胚抗原(CEA)联合C-反应蛋白(CRP)的检测对根治性直肠癌造口患者术后感染的早期诊断价值。方法选择2021年1月-2023年1月于南通大学第二附属医院接受根治性手术治疗的直肠癌患者82例作为研究对象,根据术后有无感染分为感染组(n=28)和非感染组(n=54)。统一在术前3d收集所有患者的临床资料;所有入组患者入院次日早晨空腹抽取4ml静脉血,采用全自动血液分析仪对CEA、CRP水平进行检测,比较感染组不同临床病理特征下CEA、CRP表达水平,采用受试者工作特征(ROC)曲线分析CEA、CRP水平对于直肠癌的早期诊断效能。结果感染组CEA、CRP水平均高于非感染组,均差异具有统计学意义(P<0.05);不同肿瘤大小、病理类型、白蛋白(ALB)水平的感染组患者CEA水平比较,均差异具有统计学意义(P<0.05);不同年龄、肿瘤大小、分化程度、肿瘤TNM分期、病理类型、ALB水平的感染组患者CRP水平比较,均差异具有统计学意义(P<0.05);通过ROC曲线分析发现,CEA、CRP及二者联合曲线下面积(AUC)分别为0.685、0.817和0.825(P<0.05),CEA、CRP二者联合诊断敏感性高于CEA、CRP单一诊断,差异具有统计学意义(P<0.05)。结论CEA、CRP联合检测对根治性直肠癌造口患者术后是否发生感染的诊断有较好的临床价值,能提高直肠癌临床诊断的敏感度和准确度,对CEA、CRP水平变化进行监测可为临床诊断直肠癌提供重要依据。 OBJECTIVE To investigate the value of serum carcinoembryonic antigen(CEA)combined with C-reac-tive protein(CRP)in the early diagnosis of postoperative infection in patients with radical rectal cancer.METHODS A total of 82 rectal cancer patients undergoing radical surgery in the Second Affiliated Hospital of Nan-tong University from Jan 2021 to Jan 2023 were enrolled as study subjects.They were divided into the infected group(n=28)and non-infected group(n=54)according to whether postoperative infection occurred.Clinical data of all patients were collected three days before surgery and 4 ml venous blood was taken on the morning of admis-sion,which was used to detect CEA and CRP levels.The expression levels of CEA and CRP were compared a-mong patients with different clinical and pathological characteristics in the infected group,and the efficacy of CEA and CRP in the early diagnosis of radical rectal cancer was analyzed by receiver operating characteristic(ROC)curve for rectal cancer analyzing.RESULTS The levels of CEA and CRP in the infected group were higher than those in the non-infected group,and the differences were statistically significant(P<0.05).There were significant differences in CEA levels among different tumor sizes,pathological types and ALB levels(P<0.05).There were significant differences in CRP levels among patients with different age,tumor size,differentiation degree,TNM stage,pathological type and ALB level(P<0.05).ROC curve analysis showed that CEA,CRP and AUC were 0.685,0.817 and 0.825,respective-ly(P<0.05).The sensitivity of combined diagnosis of CEA and CRP was higher than that of the individual detection,and the difference was statistically significant(P<0.05).CONCLUSION The combination of CEA and CRP has good clinical value for postoperative infection after radical rectal cancer stoma,which can improve the sensitivity and ac-curacy of clinical diagnosis of rectal cancer.Monitoring the changes of CEA and CRP levels can provide an impor-tant basis for clinical diagnosis of rectal cancer.
作者 王芳 严红燕 关维雨 杨平玉 明月 WANG Fang;YAN Hong-yan;GUAN Wei-yu;YANG Ping-yu;MING Yue(The Second Affiliated Hospital of Nantong University,Nantong,Jiangsu 226000,China)
出处 《中华医院感染学杂志》 CAS CSCD 北大核心 2024年第7期1040-1044,共5页 Chinese Journal of Nosocomiology
基金 江苏省科研基金资助项目(2021HG03210) 南通市科学技术局(指导性)项目(MSZ2022015) 南通市卫生健康委员会(指导性)项目(MSZ2022018)。
关键词 直肠癌 癌胚抗原 C-反应蛋白 术后感染 早期诊断 造口 Rectal carcinoma Carcinoembryonic antigen C-reactive protein Postoperative infection Early diag-nosis Ostomy
作者简介 王芳(1983-),女,本科,副主任护师,研究方向:造口伤口护理;通讯作者:严红燕,E-mail:877044389@qq.com。
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