The Correlation Between Preoperative Serum Tumor Markers And Clinical Stage Of Colorectal Cancer

Background: Colorectal cancer(CRC)is the third most common cancer in the world,accounting for 4th of the world's cancer mortality.There are about 1.4 million cases of colorectal cancer every year in the world.About 700,000 of these deaths are due to colorectal cancer.As the incidence of colorectal cancer continues to rise in some countries with economies in transition,the incidence of colorectal cancer is likely to continue to increase.The incidence of colorectal cancer varies widely around the world,The incidence of disease is often highest in developed countries,but it is also on the rise in developing countries,which may be associated with the improvement of living standards and the ageing of the population structure.The changes in diet structure and lifestyle are closely related.The onset of this disease is relatively hidden,and there are often no obvious early symptoms.If the disease is not diagnosed in time,it will lead to abdominal pain,abdominal distension,abscess and blood,etc.,when the disease progresses to an advanced stage.If the lesion occurs in the rectum,it may have symptoms such as acute and severe,increased defecation times and even difficult defecation.Although surgical treatment has some effect on the survival rate of the patients,it is often necessary to take radiotherapy and chemotherapy after surgery,thus increasing the psychological burden of the patients.At the same time,the economic burden also causes the patient to suffer the great harm caused by radiotherapy and chemotherapy,which greatly affects the patient's quality of life.Because the development of colorectal cancer is slow and gradual,Almost all colorectal malignancies are associated with colorectal dysplasia and the formation and malignant transformation of adenomas.Early canceration can even be cured by surgery,so efforts to reduce the number of deaths from colorectal cancer focus on early detection.Non-invasive detection methods have been widely used in clinical practice,but there are many kinds of tumor markers in clinic,so it has become a hot spot in this field to select the tumor markers which need to be detected together simply and effectively.Objective: As a simple auxiliary diagnostic method for colorectal cancer,the correlation between serum tumor markers and clinicopathological features has not been clearly concluded.The purpose of this study was to investigate the clinical significance of Carcinoembryonic antigen(CEA),Carbohydrate antigen 19-9(CA199),Carbohydrate antigen 242(CA242),Carbohydrate antigen 125(CA125),Alphafetoprotein(AFP)and Thymidine kinase 1(TK1)in clinical staging of colorectal cancer,to observe the expression of different tumor markers in patients with colorectal cancer at different clinical stages,and to evaluate the correlation between the expression of tumor markers and pathological parameters,and to provide a reference for early clinical detection of colorectal cancer and optimization of laboratory examination items.Methods: in this study,we selected 121 patients with colorectal cancer diagnosed in Qingdao Municipal Hospital from August 2016 to October 2017,and excluded 15 cases.The serum tumor markers(CEA CA19-9,CA242,CA125,AFP and TK1)were determined by electrochemiluminescence(ECL)and enzyme-immune dot blot chemiluminescence(ELISA).The clinical staging of malignant tumor was carried out by combining the postoperative pathological staging and imaging examination results.The data of patients were collected and analyzed statistically by SPSS 22.0 software.Results: 1.The positive rate of TK1 was 7.5% in 8 out of 106 colorectal cancer patients.56 out of 106,34 out of 106,9 out of 106,17 out of 106 and 4 out of 106 were increasing with the five tumor markers of CEA,CA199,CA242,CA125,AFP,and the positive rate were 52.8%,2.1%,8.5%,16.0%,3.8% respectively.The highest positive rate was CEA and the lowest positive rate was AFP.TK1 positive rate was lower than CEA,CA19-9,CA242 and CA125.2.The relationship between the age and gender: the level of expression of the 6 is not significantly different in different ages and gender.3.Relationship between six tumor markers such as CEA and clinical stage and pathological characteristics of colorectal cancer patients: Except for AFP,the expression level of the other five tumor markers in III + IV stage of colorectal cancer was higher than that in I + II stage,The difference was statistically significant(P < 0.05),and the level of lymph node metastasis or distant metastasis was higher than in the group without lymph node metastasis or without distant metastasis(P < 0.05).4.The sensitivity of the six tumor markers in serum examination of colorectal cancer patients: CEA was the highest in single detection,followed by CA19-9,CA125,CA242,TK1 and AFP.When combined or quadruple detection,the overall sensitivity was still lower than 70%,but it was significantly higher than that of single test,combine detection with CEA,CA125,CA199 and TK1 had the highest sensitivity among them.Conclusion: The expression of tumor markers is related to the clinical stage of the tumor,and preoperative combined detection of serum markers can improve the sensitivity of the diagnosis of colorectal cancer.The combined detection of CEA,CA125,CA199,TK1 is the best.