【摘要】 目的 探讨TT、Alb、CEA、CA19-9联合检测对结直肠癌与肠息肉的诊断及鉴别的价值。方法 分析青岛大学附属泰安市中心医院2019年03月至2020年7月间，经病理诊断确诊的500例结直肠癌患者作为结直肠癌组，500例肠息肉患者作为肠息肉组，并纳入同期的500名健康者为健康组。比较三组受试者的TT、Alb、CEA、CA19-9的表达水平，绘制受试者工作特征（ROC）曲线评估单独和联合检测对结直肠癌与肠息肉的诊断及鉴别诊断的效能。结果 与健康组相比，结直肠癌组TT、Alb水平均显著下降，CEA、CA19-9水平均显著升高，差异有统计学意义（Z=-11.69、-27.38、-18.32、-10.28,P均<0.05）。与健康组相比，肠息肉组TT、Alb水平均显著下降，CEA、CA19-9水平显著升高，差异有统计学意义（Z=-3.94、-15.95、-6.17、-3.70,P均<0.05）。结直肠癌组与肠息肉组相比较TT、Alb水平显著下降，CEA、CA19-9水平显著升高，差异有统计学意义（Z=-7.82、-13.69、-13.89、-7.07,P均<0.05）。ROC曲线分析显示，TT、Alb、CEA、CA19-9联合检测筛查结直肠癌的AUC为0.96，敏感性为0.870，特异性为0.956；联合检测用于筛查肠息肉的AUC为0.825，敏感性为0.684，特异性为0.836；鉴别结直肠癌与肠息肉的AUC为0.851，敏感性为0.772，特异性为0.820。结论 TT、Alb、CEA、CA19-9四项联合检测对结直肠癌筛查具有较高的临床应用价值，并且能较好的区分结直肠癌与肠息肉，可为结直肠癌的筛查及与肠息肉鉴别诊断提供参考。更多还原

【Abstract】 [ABSTACTS] Objective To explore the value of combined detection of thrombin time(TT)and albumin(Alb),carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA19-9)in the differential diagnosis of colorectal cancer and intestinal polyps. Methods 500 patients with colorectal cancer and 500 patients with intestinal polyps diagnosed by pathology at the Affiliated Taian City Central Hospital of Qingdao University were retrospectively analyzed from March 2019 to July 2020. Additionally,500 healthy volunteers were included as the control group during the same period. The expression levels of TT and Alb,CEA,CA19-9 in the three groups were compared,and a receiver operating characteristic(ROC)curve was drawn to evaluate the effectiveness of single and combined detection in diagnosing and differentiating diagnosis of colorectal cancer and intestinal polyps. Results Compared to the healthy group,the levels of TT and Alb in the colorectal cancer group were significantly decreased,while the levels of CEA and CA19-9 were significantly increased;the difference was statistically significant(Z=-11.69,-27.38,-18.32,-10.28,P<0.05). Similarly,compared to the healthy group,the levels of TT and Alb in the intestinal polyposis group were significantly decreased,while the levels of CEA and CA19-9 were significantly increased;the difference was statistically significant(Z=-3.94,-15.95,-6.17,-3.70,P<0.05). Furthermore,when comparing the intestinal polyposis group to the colorectal cancer group,the levels of TT and Alb were significantly decreased in the later,while the levels of CEA and CA19-9 were significantly increased;this difference was statistically significant(Z=-7.82,-13.69,-13.89,-7.07,P<0.05). ROC curve analysis showed that the AUC of TT and Alb,CEA,CA19-9 combined detection for colorectal cancer screening was 0.96,with a sensitivity of 0.870,and a specificity of 0.956. For screening intestinal polyps,the AUC of combined detection was 0.825,with a sensitivity of 0.684,and a specificity of0.836. The AUC of distinguishing colorectal cancer from intestinal polyps was 0.851,with a sensitivity of 0.772and a specificity of 0.820. Conclusion The combined detection of TT and Alb,CEA,and CA19-9 has high clinical value in colorectal cancer screening. It better distinguishes colorectal cancer from intestinal polyps,providing a reference for the screening and differential diagnosis of colorectal cancer and intestinal polyps.更多还原