血液炎症标志物、凝血功能指标及肿瘤标志物联合检测在结直肠癌中的临床价值研究OA

Objective To investigate the clinical value of blood inflammatory markers[neutrophil/lym-phocyte ratio(NLR),platelet/lymphocyte ratio(PLR)],coagulation function indicators[fibrinogen(FIB),D-dimer(D-D)]and tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)]in the diagnosis and treatment of colorectal cancer(CRC).Analyze the value in the periodization.Methods A to-tal of 317 patients with CRC diagnosed People's Hospital of Changshou District from January 2023 to June 2024(CRC group)and 317 patients with colorectal polyps during the same period(polyp group)were includ-ed.Differences in the levels of NLR,PLR,FIB,D-D,CEA,and CA199 were compared between the two groups;analyze the relationship between the above indexes and different TNM pathologic and clinical stages(Ⅰ,Ⅱ,Ⅲ,Ⅳ),and evaluate the differences in the indexes between patients with early-stage(T1,I)CRC pa-tients and polyp patients.A joint diagnostic model was constructed by correlation analysis and logistic regres-sion.Results The levels of NLR,PLR,FIB,D-D,CEA,and CA199 were significantly higher in the CRC group than in the polyp group(P<0.05).Compared with stage T1,the levels of NLR,PLR,FIB,D-D,CEA,and CA199 were significantly higher in patients with stage T2,T3,and T4(P<0.05).The levels of NLR,FIB,D-D,CEA and CA199 in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis,and the differences were statistically significant(P<0.05).Compared with stage M0,the levels of NLR,PLR,FIB,D-D,CEA,and CA199 in patients in stage M1 were significantly in-creased,and the differences were statistically significant(P<0.05).The later the clinical stage of the pa-tients,the higher the levels of NLR,PLR,FIB,D-D,CEA and CA199 in the serum.The levels of NLR,D-D,CEA and CA199 in stages Ⅲ and Ⅳ were significantly higher than those in stages Ⅰ and Ⅱ.The levels of NLR,PLR,FIB,D-D,CEA and CA199 in stage Ⅳ were significantly increased compared with those in stageⅠ,and the differences were statistically significant(P<0.05).In early stage CRC(stage T1 and stage Ⅰ),the levels of NLR,FIB,D-D,and CEA in stage T1 and the levels of FIB,D-D,and CEA in stage Ⅰ were signif-icantly higher than those in the polyp group,and the differences were statistically significant(P<0.05).In patients with CRC,the levels of NLR,FIB,and D-D were positively correlated with CEA(r=0.322,0.321 and 0.316,P<0.05),and D-D was positively correlated with CA199(r=0.382,P<0.05).The AUC of the combined diagnosis of early CRC by FIB+D-D+CEA+CA199 was 0.819(P<0.001).Conclusion Blood in-flammatory indicators,coagulation indicators and tumor markers are closely related to the progression and me-tastasis of CRC.The combined detection of multiple indicators can enhance the efficiency of early diagnosis and provide non-invasive auxiliary basis for the staging assessment and prognosis management of CRC.