| 戴龙飞,任之尧,王旭,等.红细胞分布宽度、白蛋白、血小板 /淋巴细胞比值及癌胚抗原在低癌胚抗原结直肠癌筛查中的预测价值[J].安徽医药,2023,27(11):2220-2223. |
| 红细胞分布宽度、白蛋白、血小板 /淋巴细胞比值及癌胚抗原在低癌胚抗原结直肠癌筛查中的预测价值 |
| Predictive value of red blood cell distribution width, albumin, platelet/lymphocyte ratio, and carcinoembryonic antigen on screening patients with low CEA level colorectal cancer |
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| DOI：10.3969/j.issn.1009-6469.2023.11.022 |
| 中文关键词: 结直肠肿瘤 早期诊断 癌胚抗原 血清指标 筛查 |
| 英文关键词: Colorectal neoplasms Early diagnosis Carcinoembryonic antigen Blood serum indicators Screening |
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| 中文摘要: |
| 目的评估红细胞分布宽度( RDW)、白蛋白( ALB)、血小板 /淋巴细胞比值( PLR)及癌胚抗原( CEA)在低 CEA结直肠癌筛查中的预测价值。方法选取 2017年 7月至 2020年 10月在安徽医科大学第一附属医院就诊或体检者 800例，其中低 CEA结直肠癌病人 300例；非结直肠癌病人 500例(包括结直肠良性肿瘤病人 250例和健康体检者 250例)。采用非参数 Mann-Whitney U检验，选出有组间差异的血清学指标。通过多因素 logistic回归及受试者操作特征( ROC)曲线分析血清标志物的预测价值。结果非结直肠癌组与低 CEA结直肠癌组 RDW［42.70(40.80，44.80)比 43.70(41.90，46.20)］、血小板分布宽度(PDW)［13.70(12.10，15.80)比 13.10(11.60，15.10)］、血小板平均容积( MPV)［11.30(10.60，12.20)比 10.80(10.20，11.80)］、 ALB［44.80(42.33，46.80)g/L比 41.70(38.70，44.30)g/L］、前白蛋白浓度( PA)［277.00(242.00，310.50)比 244.00(199.00，286.25)］、糖类抗原( CA199)［9.94(6.42，15.14)μg/L比 8.77(5.68，13.62)μg/L］、 CEA［1.60(1.00，2.30)μg/L比 2.10(1.46，3.10)μg/L］、中性粒细胞 /淋巴细胞比值( NLR)［1.69(1.36，2.20)比 2.09(1.65，2.85)］、 PLR［112.90(88.91，140.25)比 136.18(106.54，187.12)］和单核细胞 /淋巴细胞比值( MLR)［0.17(0.14，0.22)比 0.23(0.17，0.31)］差异有统计学意义。而 RDW、ALB、PLR及 CEA是低 CEA水平结直肠癌的独立危险因素。 RDW+ALB+CEA+PLR联合筛查低 CEA结直肠癌价值最高( AUC=0.77)。当 RDW+ALB+CEA+PLR >?0.37，体检者患结直肠癌的可能性大。结论 RDW+ALB+CEA+PLR联合筛查低 CEA结直肠癌病人价值最高，其筛查价值优于单个标志物。作为一种更敏感和更具成本效益的策略，这种方法可以在常规结直肠癌筛查中进行。 |
| 英文摘要: |
| Objective To assess the predictive value of red blood cell distribution width (RDW), albumin (ALB), platelet/lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA) on screening patients with low CEA level colorectal cancer.Methods A total of 800 patients who attended the First Affiliated Hospital of Anhui Medical University from July 2017 to October 2020 were retrospectively collected, including 300 patients with low-CEA colorectal cancer, and 500 patients with non-colorectal cancer (250 patients with benign colorectal tumors and 250 healthy physical examiners). A nonparametric Mann-Whitney U test was performed between the twogroups to select the serological indicators with intergroup differences. Finally, the predictive value of serologic markers was explored bymultifactorial logistic regression analysis and ROC analysis.Results Red blood cell distribution width (RDW) [42.70 (40.80, 44.80) vs. 43.70 (41.90, 46.20)], platelet distribution width (PDW) [13.70 (12.10, 15.80) vs. 13.10 (11.60, 15.10)], mean platelet volume (MPV) [11.30(10.60, 12.20) vs. 10.80 (10.20, 11.80)], albumin concentration (ALB) [44.80 (42.33, 46.80) g/L vs. 41.70 (38.70, 44.30) g/L], pre‐albumin concentration (PA) [277.00 (242.00, 310.50) vs. 244.00 (199.00, 286.25)], glycocalyx antigen (CA199) [9.94 (6.42, 15.14) μg/L vs. 8.77 (5.68, 13.62) μg/L], carcinoembryonic antigen (CEA) [1.60 (1.00, 2.30) μg/L vs. 2.10 (1.46, 3.10) μg/L], neutrophil/lymphocyte ratio (NLR) [1.69 (1.36, 2.20) vs. 2.09 (1.65, 2.85)], platelet/lymphocyte ratio (PLR) [112.90 (88.91, 140.25) vs. 136.18 (106.54, 187.12)] and monocyte/ lymphocyte ratio (MLR) [0.17 (0.14, 0.22) vs. 0.23 (0.17, 0.31)] were statistically significantly different. WhileRDW, ALB, PLR, and CEA were independent risk factors for colorectal cancer with low CEA levels, the combination of RDW+ALB+CEA+PLR had the highest screening value for colorectal cancer with low CEA (AUC=0.77). When RDW+ALB+CEA+PLR> ? 0.37,physical examiners were more likely to have colorectal cancer.Conclusions The combination of RDW+ALB+CEA+PLR has the highest value for screening patients with low CEA level colorectal cancer and its screening value is superior to that of individual markers.As a more sensitive and cost-effective strategy, this approach can be performed in routine colorectal cancer screening. |
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