结直肠癌患者外周血中性粒细胞与淋巴细胞比值、D-二聚体、癌胚抗原、糖类抗原19-9和糖类抗原72-4单一及联合检测的临床意义OACHSSCD
Clinical significance of single and combined detection of neutrophil-to-lymphocyte ratio,D-dimer,carcinoembryonic antigen,carbohydrate antigen 19-9,and carbohydrate antigen 72-4 in peripheral blood of patients with colorectal cancer
目的 评估外周血中性粒细胞与淋巴细胞比值(NLR)、D-二聚体(DD)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)及糖类抗原 72-4(CA72-4)单项及联合检测在结直肠癌(CRC)诊断中的临床价值.方法 研究于2024 年1 月至 12 月在吉林市人民医院开展.观察组由该期间内经病理确诊的 102 例 CRC 患者组成,对照组为同期接受健康体检的 51 例健康个体.采集外周血检测 NLR、DD、CEA、CA19-9 及 CA72-4 水平.比较两组间各指标的差异,并分别计算基于常规参考范围的各指标及常规联合检测(任一项阳性即判为阳性)的阳性率.通过受试者工作特征(ROC)曲线评估各单项与联合指标的诊断性能,并采用二元 logistic 回归构建加权联合诊断模型.结果 对照组 NLR、DD、CEA 及 CA19-9 水平均显著低于观察组(均 P<0.05),而 CA72-4水平两组间差异无统计学意义.基于常规参考范围的常规联合检测(NLR、DD、CEA、CA19-9 任一项阳性)阳性率为90.20%(92/102),显著高于任一单项指标(均 P<0.05).ROC 曲线分析显示,NLR、DD、CEA、CA19-9单项诊断的曲线下面积(AUC)分别为0.827、0.750、0.843 和0.630.进一步构建的加权联合诊断模型 AUC 达0.924[95%CI(0.883,0.966)],灵敏度为 87.3%,特异度为 84.3%,其诊断效能显著优于各单项指标(均P<0.01).结论 NLR、DD、CEA 和 CA19-9是 CRC 的有效辅助诊断指标,基于二元logistic 回归构建的加权联合诊断模型具有较高的诊断准确性,可作为临床辅助诊断的有效工具.本研究提示CA72-4在本队列中的诊断价值有限.
Objective To evaluate the clinical value of single and combined detection of neutrophil-to-lymphocyte ratio(NLR),D-dimer(DD),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and carbohydrate antigen 72-4(CA72-4)in peripheral blood for the diagnosis of colorectal cancer(CRC).Methods The study was conducted at Jilin People's Hospital from January to December 2024.The observation group consisted of 102 CRC patients diagnosed by pathology during this period,while the control group included 51 healthy individuals who underwent health check-ups during the same period.Peripheral blood samples were collected to measure NLR,DD,CEA,CA19-9,and CA72-4 levels.Differences in these indicators between the two groups were compared.Positive rates were calculated for individual markers and for conventional combined detection(defined as positivity if any one of NLR,DD,CEA,or CA19-9 exceeded the conventional reference threshold).The diagnostic performance of each individual and combined indicator was assessed using receiver operating characteristic(ROC)curve analysis,and a weighted combined diagnostic model was constructed by binary logistic regression.Results The levels of NLR,DD,CEA,and CA19-9 in the control group were significantly lower than those in the observation group(all P<0.05),while the difference in CA72-4 levels between the two groups was not significant.The positive rate of conventional combined detection(any of NLR,DD,CEA,or CA19-9 positive)was 90.20%(92/102),significantly higher than that of any single marker(all P<0.05).ROC curve analysis revealed that the areas under the curve(AUCs)for NLR,DD,CEA,and CA19-9 alone were 0.827,0.750,0.843,and 0.630,respectively.The weighted combined diagnostic model achieved an AUC of 0.924[(95%CI(0.883,0.966)],with a sensitivity of 87.3%and a specificity of 84.3%.Its diagnostic performance was significantly superior to that of any single marker(all P<0.01).Conclusion NLR,DD,CEA,and CA19-9 are effective auxiliary diagnostic indicators for CRC.The weighted combined diagnostic model based on binary logistic regression demonstrates high diagnostic accuracy and may serve as a useful tool in clinical auxiliary diagnosis.CA72-4 showed limited diagnostic value in this cohort.
迟艳新;祝宏伟;齐菲;赵伟
吉林市人民医院检验科,吉林 吉林 132001吉林市人民医院检验科,吉林 吉林 132001吉林市人民医院检验科,吉林 吉林 132001吉林市人民医院检验科,吉林 吉林 132001
医药卫生
结直肠肿瘤癌胚抗原糖类抗原19-9中性粒细胞与淋巴细胞比值D-二聚体糖类抗原72-4联合检测诊断效能
colorectal neoplasmscarcinoembryonic antigencarbohydrate antigen 19-9neutrophil-to-lymphocyte ratioD-dimercarbohydrate antigen 72-4combined detectiondiagnostic performance
《空军军医大学学报》 2026 (4)
589-593,5
吉林市科技创新发展计划项目(20230406147)
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