Predictive Value Of CEA、CA199 And FIB For Staging Of Colorectal Cancer

Objective:Colorectal cancer is a common malignant tumor in clinical,and different clinical stage determines the prognosis.The common tumor markers detection value present different expression in patients with benign and malignant tumor,and different level of staging in patients with malignant tumor is different also.The article discusses preoperative carcinoembryonic antigen、carbohydrate antigen 199 and fibrinogen expression level and the correlation between postoperative pathologic TNM staging,and to evaluate the clinical application value of the three values in postoperative staging of colorectal cancer.Methods:A total of 74 patients with colorectal cancer who met the conditions in our hospital from December 2015 to January 2017 were collected and 79 patients with colorectal polyp in the same period were collected as the control group.Plasma FIB、CEA and CA199 were collected by coagulation and chemiluminescence immunoassay in 2 weeks.Collect other relevant data of patients as required,and use SPASS22.0 software for statistical analysis.Results:1、The early diagnosis is the key to radical surgery.The proportion of radical surgery in stage Ⅰ was 100%,and the rate of radical surgery was 91.18%in advanced.2、The levels of FIB、CEA and CA199 in the 74 patients in the case group were higher than those in the control group,and the difference was statistically significant(p<0.05).The FIB level of patients in the case group was significantly higher than that in the control group.3、The accuracy of FIB in single test is the best,the area under ROC curve(AUC)is 0.698,and the sensitivity is 45.95%.The accuracy of parallel joint detection is highest,AUC is 0.767,sensitivity is 64.86%and diagnostic is medium.4、The positive rate of FIB、CEA and parallel detection of colorectal cancer was higher than the control group,and the positive rate of all tumor markers in TNM Ⅲ Ⅳ was higher than the control group.5、The level of FIB and CEA before surgery was related to tumor infiltration depth(p<0.05,p2<0.01);The level of CA199 was associated with lymph node metastasis(p<0.01);At the same time,the preoperative CEA level was also associated with positive lymph node metastasis(P<0.01),and the positive rate of lymph node metastasis increased to 59.26%.6、Single factor analysis showed that tumor infiltration depth in colorectal cancer patients was related to tissue differentiation、tumor markers and lymph node metastasis(p<0.05).Lymph node metastasis was associated with the degree of tissue differentiation、tumor markers and tumor infiltration(p<0.05).7、TNM staging of colorectal cancer was positively correlated with the content of three tumor markers,and the difference was statistically significant(p<0.05).The best correlation strength is CEA,whose correlation coefficient r is 0.335;The least closely related relation is FIB,whose correlation coefficient r is 0.265.The higher the preoperative value of CEA and CA199,the higher the rate of progress(P=0.000<0.01).Conclusion:1、The higher the expression of FIB、CEA and CA199 in patients with colorectal cancer in CRC,it suggests late stage.CRC patients have hypercoagulability-2、FIB as a tumor marker indirectly reflecting CRC,has the highest sensitivity and accuracy of single detection CRC,which can be used as a better screening method.3、Polyps with a diameter of more than 1cm and a positive marker of polyp should be treated as early as possible in electronic colonoscopy.4、CEA is a reliable tumor marker,with relatively stable sensitivity and specificity.It also has certain clinical value in preoperative staging and prognosis of colorectal cancer.5、CA199 has no statistical significance in the diagnosis of early CRC(p>0.05),but it has certain predictive value for the CRC metastasis in the advanced stage,which is very instructive in clinical.6、Tumor staging determines the prognosis of patients.FIB、CEA and CA199 had positive correlation with TNM staging,and the value of tumor markers increased more rapidly with the progress of stages.This can be used to evaluate preoperative staging,to provide ideas for the selection of the next treatment plan,and to predict the prognosis of patients.7、The joint detection of tumor markers improved the early CRC diagnosis efficiency and improved the radical operation rate,but the final diagnosis and treatment still required the participation of MDT.