Altern Ther Health Med. 2023 Sep;29(6):192-197.
OBJECTIVE: To investigate the clinical diagnostic and prognostic value of preoperative serum tumor markers in patients with colorectal cancer (CRC). METHODS: From September 2013 to September 2016, we enrolled 980 patients diagnosed with CRC and 870 healthy subjects from The Affiliated Cancer Hospital of Shanxi Medical University. Patients were grouped and compared in accordance with tumor stage, tumor location, lymph node metastasis, distant metastasis, histological type, depth of invasion, growth type, and other factors. Serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and carbohydrate antigen 24-2 (CA24-2) concentrations in patient peripheral blood were measured, and the diagnostic value of the tumor markers in diagnosing CRC was assessed by receiver operating characteristic analysis. RESULTS: The sensitivity of serum tumor markers in combination was significantly higher than serum tumor markers detected individually. CA19-9 levels were significantly correlated with CA24-2 levels (r = 0.884; P < .001) in patients with CRC. The preoperative CEA, CA19-9, and CA24-2 levels in patients with colon cancer were significantly higher than in patients with rectum cancer (all P < .001). The CA19-9 and CA24-2 levels were significantly higher in patients with lymph node metastasis than without (both P < .001). In addition, the CEA, CA19-9, and CA24-2 levels in patients with distant metastasis were significantly higher than those in patients without metastasis (all P < .001). Stratified analysis showed that CEA, CA19-9, and CA24-2 levels were significantly correlated with TNM staging (P < .05). With regard to the depth of tumor invasion, CEA, CA19-9, and CA24-2 levels in tumors outside the serosa were significantly higher than those in other tumor types (P < .05). In terms of diagnostic performance, CEA had a sensitivity of 0.52 and a specificity of 0.98, CA19-9 had a sensitivity of 0.35 and a specificity of 0.91, and CA24-2 had a sensitivity of 0.46 and a specificity of 0.95. CONCLUSION: The detection of serum tumor markers CEA, CA19-9, and CA24-2 is a good method for supporting diagnosis, making treatment decisions, judging therapeutic effect, and predicting prognosis when managing patients with CRC.
目的：探讨术前血清肿瘤标志物对结直肠癌（CRC）患者的临床诊断和预后价值。
方法：2013 年 9 月至 2016 年 9 月，我们纳入了 980 例确诊为 CRC 的患者和 870 例健康对照者，这些患者均来自山西医科大学附属肿瘤医院。我们根据肿瘤分期、肿瘤位置、淋巴结转移、远处转移、组织学类型、浸润深度、生长方式等因素对患者进行分组和比较。检测患者外周血中癌胚抗原（CEA）、糖链抗原 19-9（CA19-9）和糖链抗原 24-2（CA24-2）的浓度，通过受试者工作特征分析评估肿瘤标志物对 CRC 的诊断价值。
结果：血清肿瘤标志物联合检测的灵敏度明显高于单独检测。CRC 患者血清 CA19-9 水平与 CA24-2 水平显著相关（r=0.884；P<0.001）。结肠癌患者的术前 CEA、CA19-9 和 CA24-2 水平明显高于直肠癌患者（均 P<0.001）。有淋巴结转移的患者的 CA19-9 和 CA24-2 水平明显高于无转移的患者（均 P<0.001）。此外，有远处转移的患者的 CEA、CA19-9 和 CA24-2 水平明显高于无转移的患者（均 P<0.001）。分层分析显示，CEA、CA19-9 和 CA24-2 水平与 TNM 分期显著相关（P<0.05）。就肿瘤浸润深度而言，浆膜外肿瘤的 CEA、CA19-9 和 CA24-2 水平明显高于其他肿瘤类型（P<0.05）。在诊断性能方面，CEA 的灵敏度为 0.52，特异性为 0.98，CA19-9 的灵敏度为 0.35，特异性为 0.91，CA24-2 的灵敏度为 0.46，特异性为 0.95。
结论：检测血清肿瘤标志物 CEA、CA19-9 和 CA24-2 是支持结直肠癌患者诊断、制定治疗决策、判断治疗效果和预测预后的良好方法。
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