-
摘要:目的
探讨直肠上皮细胞稳定性FH检测在直肠恶性肿瘤早期筛查中的诊断价值。
方法300例被检者均行直肠上皮细胞稳定性FH、CEA和CA19-9检测。以病理学诊断结果为金标准，辅以电子结肠镜检查，分析上皮细胞稳定性FH、CEA和CA19-9检测对直肠恶性肿瘤筛查的敏感度、特异性、假阴性率（漏诊率）、假阳性率（误诊率）、阴性似然比、阳性似然比、诊断指数、约登指数、粗符合率、阴性预测值、阳性预测值等指标。
结果经上皮细胞稳定性FH检测直肠恶性肿瘤患者阳性率高于CEA和CA19-9检测（P=0.000）。40例直肠恶性肿瘤患者中上皮细胞稳定性FH检测出阳性患者38例（95%），CEA检测出阳性患者23例（57.50%），CA19-9检测出阳性患者10例（25.00%）。上皮细胞稳定性FH检测的敏感度、阳性似然比、诊断指数、约登指数、阴性预测值、阳性预测值均高于CEA和CA19-9检测，假阴性率和阴性似然比均低于CEA和CA19-9检测。
结论上皮细胞稳定性FH检测在直肠恶性肿瘤筛查中检测结果有较高的敏感度、阳性似然比、诊断指数、约登指数、阴性预测值、阳性预测值，较低的假阴性率和阴性似然比。
-
关键词:
- 直肠上皮细胞稳定性FH检测 /
- 直肠恶性肿瘤 /
- CEA /
- CA19-9 /
- 肿瘤筛查
Abstract:ObjectiveTo investigate the diagnostic value of rectal epithelial cells stability FH for the early screening of rectal cancer.
MethodsFH, CEA and CA19-9 were performed in 300 patients. We used pathological diagnostic results as the gold standard and electronic colonoscopy as an assistance to analyze the detection indicators of epithelial cells stability FH, CEA and CA19-9 test for screening rectal malignancy, such as sensitivity(Sen), specificity(Spe), false negative rate(missed diagnosis rate), false positive rate (the misdiagnosis rate), negative likelihood ratio (LR), positive likelihood ratio (LR+), diagnosis index (DI), Youden index, crude coincidence rate (CA), negative predictive value (PV-) and positive predictive value (PV+), etc.
ResultsThe positive rate of epithelial cell stability FH test for rectal malignant tumor was higher than those of CEA and CA19-9 (P=0.000). Among the 40 cases of rectal malignant tumor, 38 positive cases(95%) were detected by epithelial cell stability FH, 23 positive cases(57.5%) were detected by CEA, 10 positeve cases(25%) were detected by CA19-9. The sensitivity, positive likelihood ratio, diagnostic index, Youden index, negative predictive value and positive predictive value of FH were all higher than those of CEA and CA19-9, while the false negative rate and negative likelihood ratio were lower than CEA and CA19-9.
ConclusionThere are higher sensitivity, positive likelihood ratio, diagnostic index, Youden index, negative predictive value, positive predictive value, lower false negative rate and negative likelihood ratio of epithelial cells stability FH in rectal cancer screening.
-
Key words:
- Rectal epithelial cells stability FH test /
- Rectal malignant tumor /
- CEA /
- CA19-9 /
- Tumor screening
-
作者贡献马茜： 采集样本、收集患者资料、撰写论文黄晓明、郭亚苹： 采集样本、收集患者资料高记华： 指导试验及论文书写高策、戚文月、郭虹君： 采集样本、收集患者资料
-
表 3 肿瘤患者CEA、CA19-9检测分别与FH检测结果比较(n)
Table 3 Comparison of test results between CEA, CA19-9 and FH in tumor patients (n)
下载: 导出CSV
表 4 肿瘤术后（未复发）患者CEA、CA19-9检测分别与FH检测结果比较(n)
Table 4 comparison of CEA, CEA and ca19-9 test results with FH test results in the patients of postoperative tumor (no recurrence) (n)
下载: 导出CSV
表 5 直肠肿瘤、非肿瘤三种方法检测结果(n)
Table 5 Detection of rectal tumors and non-tumor results by three methods (n)
下载: 导出CSV
表 6 直肠恶性肿瘤三种检测方法与病理学检测结果比较
Table 6 Comparison between three detection methods results for rectal malignancy and pathological detection results
下载: 导出CSV
-
[1] 郑晓金, 李凯, 欧凤荣.结直肠癌相关危险因素研究进展[J].实用药物与临床, 2018, 21(10): 116-9. http://d.old.wanfangdata.com.cn/Periodical/lnywylc201810028 Zheng XJ, Li K, Ou FR. Research progress on risk factors for colorectal cancer[J]. Shi Yong Yao Wu Yu Lin Chuang, 2018, 21(10): 116-9. http://d.old.wanfangdata.com.cn/Periodical/lnywylc201810028
[2] 亓云鹏.消化内镜技术对消化道肿瘤的早期诊断与治疗价值[J].世界最新医学信息文摘, 2018, 18(A2): 209, 212. http://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201704026.htm Qi YP. Value of digestive endoscopy in early diagnosis and treatment of gastrointestinal tumors[J]. Shi Jie Zui Xin Yi Xue Xin Xi Wen Zhai, 2018, 18(A2): 209, 212 http://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201704026.htm
[3] Waldmann E, Regula J, Ferlitsch M. How can screening colonoscopy be optimized?[J]. Dig Dis, 2015, 33(1): 19-27. doi: 10.1159/000366033
[4] 陈舒颖, 邱芳华, 李秋明, 等.血清DCD、CA199、CA724和CEA联合检测对大肠癌的诊断价值[J].实用医学杂志, 2017, 33(15): 64-7. http://d.old.wanfangdata.com.cn/Periodical/syyxzz201715014 Chen SY, Qiu FH, Li QM, et al. Value of cobined detection of serum DCD, CA199, CA724, and CEA in diagnosis of colorectal cancer[J]. Shi Yong Yi Xue Za Zhi, 2017, 33(15): 64-7. http://d.old.wanfangdata.com.cn/Periodical/syyxzz201715014
[5] 房静远, 时永全, 陈萦晅, 等.中国结直肠癌预防共识意见(2016年, 上海)[J].胃肠病学, 2016, 21(11): 668-86. doi: 10.3969/j.issn.1008-7125.2016.11.006 Fang JY, Shi YQ, Chen YX, et al. Consensus on the prevention of colorectal cancer in China(Shanghai, 2016)[J]. Wei Chang Bing Xue, 2016, 21(11): 668-86. doi: 10.3969/j.issn.1008-7125.2016.11.006
[6] 孙燕, 顾晋, 汪建平.中国结直肠癌诊疗规范(2017年版)[J].上海医学, 2018, 41(8): 449-63. http://d.old.wanfangdata.com.cn/Periodical/zhwk201804001 Sun Y, Gu J, Wang JP. Standard for diagnosis and treatment of colorectal cancer in China(2017 edition)[J]. Shanghai Yi Xue, 2018, 41(8): 449-63. http://d.old.wanfangdata.com.cn/Periodical/zhwk201804001
[7] Kühl T, Imhof D. Regulatory Fe(Ⅱ/Ⅲ) heme: the reconstruction of a molecule's biography.[J]. Chembiochem, 2014, 15(14): 2024-35. doi: 10.1002/cbic.201402218
[8] 陈艳辉, 周训华, 赵莹.子宫上皮细胞稳定性细胞游离亚铁原卟啉对宫颈癌的诊断意义[J].中国医药导报, 2018, 15(2): 79-82. http://d.old.wanfangdata.com.cn/Periodical/yycyzx201802020 Chen YH, Zhou XH, Zhao Y. The diagnostic significance of the uterine epithelial cells stability of the cells free ferrous protoporphyrin for cervical cancer[J]. Zhongguo Yi Yao Dao Bao, 2018, 15(2): 79-82. http://d.old.wanfangdata.com.cn/Periodical/yycyzx201802020
[9] Kim YJ, Munsell MF, Park JC, et al. Retrospective review of symptoms and palliative care interventions in women with advanced cervical cancer[J]. Gynecol Oncol, 2015, 139(9): 553-8. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=21005d1d742c40097b755334629ef7bc
[10] 王小丹, 刘珊, 徐海滨, 等.重组人乳铁蛋白对缺铁性贫血大鼠铁营养状况的改善作用[J].卫生研究, 2012, 41(1): 137. http://d.old.wanfangdata.com.cn/Periodical/wsyj201201003 Wang XD, Liu S, Xu HB, et al. Effect of recombinant human lactoferrin on iron nutrition in rats with iron deficiency anemia[J]. Wei Sheng Yan Jiu, 2012, 41(1): 137. http://d.old.wanfangdata.com.cn/Periodical/wsyj201201003
[11] 王永峰, 杜成林, 李保海, 等. COX-2和突变型p53在人胶质细胞瘤组织中的表达及意义[J].山东医药, 2014, 54(26): 80-1. doi: 10.3969/j.issn.1002-266X.2014.26.033 Wang YF, Du CL, Li BH, et al. Expression and significance of COX-2 and mutant p53 in human Glioblastoma[J]. Shandong Yi Yao, 2014, 54(26): 80-1. doi: 10.3969/j.issn.1002-266X.2014.26.033
[12] 徐光. EGFR、p53、Fascin蛋白在鼻咽癌组织中表达[J].中国公共卫生, 2015, 31(10): 1356-8. doi: 10.11847/zgggws2015-31-10-35 Xu G. Protein expressions of EGFR, p53, and fascin in nasopharyngeal carcinoma tissue and their clinical significance[J]. Zhongguo Gong Gong Wei Sheng, 2015, 31(10): 1356-8. doi: 10.11847/zgggws2015-31-10-35
[13] Lehtinen M, Lagheden C, Luostarinen T, et al. Ten-year follow-up of human papillomavirus vaccine efficacy against the most stringent cervical neoplasia end-point-registry-based follow-up of three cohorts from randomized trials[J]. BMJ Open, 2017, 7(8): e015867. doi: 10.1136/bmjopen-2017-015867
[14] 姚前尹, 林绍强, 李囡, 等.亚铁螯合酶抑制诱导细胞内原卟啉Ⅸ积聚的肿瘤荧光成像[J].暨南大学学报(医学版), 2011, 32(4): 387-92. http://d.old.wanfangdata.com.cn/Periodical/jndxxb201104007 Yao QY, Lin SQ, Li N, et al. Tumor fluorescence detection technique researches on accumulation of protoporphyrin-Ⅸ in cancer cells induced by FECH-siRNA[J]. Ji'nan Da Xue Xue Bao(Yi Xue Ban), 2011, 32(4): 387-92. http://d.old.wanfangdata.com.cn/Periodical/jndxxb201104007
计量
- 文章访问数: 2273
- HTML全文浏览量: 393
- PDF下载量: 430
