| Objective: To investigate the expressive and diagnostic value of detecting the preoperational and postoperational CRP, CEA, CA125, CA19-9 and AFP levels in the blood serum of patients with malignant and benign inflammatory diseases of digestive system, we explored the clinical significance of combined detection of CRP and tumor markers and evaluated their accuracies and consistencies with the analysis of ROC curves.Methods:We analyzed 225 cases, including146 cases with malignant tumor and 79 cases with benign inflammatory diseases of digestive system, 76 healthy volunteers as control. We detected the levels of the tumor marker(TM) CEA, AFP, CA125, CA19-9 and CRP using the chemiluminescent immunoassay and the immunonephelometry, respectively. The sensitivity, specificity, Youden's index and Kappa were calculated by SPSS.Results:1,The mean concentrations of CEA, AFP, CA125, CA19-9 and CRP in malignant tumor group and benign inflammatory group were significantly increased compared to those in control group; The level of CRP in malignant tumor group was lower significantly than that in benign inflammatory group (P=0.024<0.05). The levels of TM were higher in malignant tumor group than that in benign inflammatory group.2,The positive rate of CRP in malignant tumor group was higher before surgical than after surgical (P=0.00<0.01), which was also higher significantly with compared with the control group (P=0.00<0.01). Butthere was no difference in preoperational CRP between in malignant tumor and in benign inflammatory group (P=0.268>0.05). After surgical, the positive rate of CRP in benign inflammatory group was higher significantly than that in the control group (P=0.00<0.01).3,Their diagnostic value of our study was evaluated by ROC analysis of statistical method. When the healthy volunteers group was used as the control, the areas of under ROC curve (AUC) of CRP, CEA, AFP, CA125 and CA19-9 in the malignant tumor group were 0.700, 0.692, 0.750, 0.741, 0.679, respectively. The diagnostic accuracies of CRP and TM were medium. The value of accuracy and screening of CRP was highest. The diagnostic value of TM was very low. If the benign inflammatory group was used as the control, the AUC of CRP in the malignant tumor group before surgical was only 0.325. If five items were combined, the AUC was 0.815. The diagnostic accuracy was superior to individual item.4,Combined assay of CRP, CEA, CA125, CA19-9 and AFP with parallel in the malignant tumor group, five items were complementary. Apart from specificity, the sensitivity, total consistent rate, Kappa and YI of the combined assay were superior to individual test. In benign inflammatory, the sensitivity, specificity, total consistent rate, Kappa and YI of CRP were best before surgical.Conclusion:1,The levels of serum CRP increased in malignant tumor and benign inflammatory diseases of digestive system. It suggested CRP is related with the digestive diseases. CRP can be a good diagnostic and auxiliary index. It is helpful to detect CRP for diagnosis of malignant and inflammatory diseases of digestive system.2,There were higher-level expression and higher positive rate of CRP in malignant tumor and inflammatory diseases. CRP in inflammatory disease returned to normal level on 7th day after surgical. But, CRP in malignant tumor disease maintained high level. Therefore the dynamic monitoring of CRP in digestive diseases is valuable to estimate the diagnosis and prognosis.3,CRP could be a good complementary to CEA, CA125, CA19-9 and AFP. If CRP combined with TM by the parallel determination, therewere good sensitivity, total consistent rate, Kappa and YI. Combined assay were superior to individual test except specificity. Therefore, combined assay can improve greatly diagnostic rate and screening for digestive malignant disease. The clinical value of measurement is important. |
