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评价多种生物指标联合诊断结直肠癌转移的价值:基于 1163 例患者的回顾性研究。

Evaluation of multiple biological indicators for the combined diagnosis of metastases from colorectal cancer-a retrospective study based on 1163 patients.

机构信息

Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, China.

General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China.

出版信息

World J Surg Oncol. 2023 Jul 28;21(1):229. doi: 10.1186/s12957-023-03108-4.

Abstract

OBJECTIVE

This study aimed to investigate the efficacy of inflammatory markers (NLR, PLR) combined with tumor markers (CA50, CA199, CEA) in the diagnosis of colorectal cancer metastasis by a single-center retrospective study.

METHODS

A total of 1163 CRC patients who received treatments in our hospital from January 2017 to December 2021 were enrolled retrospectively. Patients were grouped according to the absence of metastasis. The separate efficacy of tumor markers, NLR and PLR, was evaluated in the diagnosis of metastasis of colorectal cancer using ROC curve analysis, and their optimal cut-off values for distant metastases from colorectal cancer were determined. The area under the ROC curve (AUC) of the tumor markers combined with NLR and PLR was calculated by binary logistic regression analysis to evaluate the diagnostic efficacy of metastasis of colorectal cancer. In addition, patients were divided into two groups of high and low levels according to the optimal cut-off values, and the effects of NLR, PLR, and tumor markers on distant metastasis of colorectal cancer were evaluated using multiple logistic regression analysis.

RESULT

The abnormal rate of CA50, CA199, CEA, NLR, and PLR in two subgroupsIt was statistically significant (P < 0.05). After AUC testifying, the diagnostic efficacy of NLR and PLR was equivalent to that of tumor marker (P > 0.05). In assessment of liver metastasis, peritoneal metastasis, and multiple metastasis, AUC of NLR and PLR with CRC-specific tumor markers showed higher predictive efficacy than AUC without combined NLR nor PLR. The CA50, CA199, CEA, PLR, and NLR were proved independently associated with metastasis using multiple logistic regression analysis (P < 0.05).

CONCLUSION

NLR and PLR are noted tumor markers of colorectal cancer, which are characterized by noninvasive, high diagnostic efficacy, easy availability, and low cost. They can be combined with traditional tumor markers to evaluate and diagnose colorectal cancer metastasis by clinicians.

摘要

目的

本研究旨在通过单中心回顾性研究探讨炎症标志物(NLR、PLR)联合肿瘤标志物(CA50、CA199、CEA)在结直肠癌转移诊断中的疗效。

方法

回顾性纳入 2017 年 1 月至 2021 年 12 月在我院接受治疗的 1163 例 CRC 患者。根据有无转移将患者分组。采用 ROC 曲线分析评估肿瘤标志物、NLR 和 PLR 单独对结直肠癌转移的诊断效果,并确定其诊断结直肠癌远处转移的最佳截断值。采用二元逻辑回归分析计算肿瘤标志物联合 NLR 和 PLR 的 ROC 曲线下面积(AUC),以评估结直肠癌转移的诊断效果。此外,根据最佳截断值将患者分为高低两组,采用多因素逻辑回归分析评估 NLR、PLR 和肿瘤标志物对结直肠癌远处转移的影响。

结果

两组患者的 CA50、CA199、CEA、NLR 和 PLR 异常率比较,差异均有统计学意义(P<0.05)。AUC 检验后,NLR 和 PLR 的诊断效能与肿瘤标志物相当(P>0.05)。在评估肝转移、腹膜转移和多发转移时,联合 NLR 或 PLR 的 CRC 特异性肿瘤标志物的 AUC 预测效能高于不联合 NLR 和 PLR 的 AUC。多因素逻辑回归分析结果显示,CA50、CA199、CEA、PLR 和 NLR 与转移均独立相关(P<0.05)。

结论

NLR 和 PLR 是结直肠癌有前途的肿瘤标志物,具有无创、诊断效能高、易获取、成本低等特点。可与传统肿瘤标志物联合,由临床医生用于评估和诊断结直肠癌转移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c14/10375667/d3995cc6aced/12957_2023_3108_Fig1_HTML.jpg

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