| Objective To explore the differential expression and diagnostic value of heat shock protein 90α(HSP90α)and carcinoembryonic antigen(CEA)and carbohydrate antigen-199(CA-199)in early,middle and late stage and high-risk colorectal adenomas compared with healthy controls.Blood test is of great significance in the diagnosis and exclusion of gastrointestinal tumors.In addition,the elevated level of tumor markers has a certain diagnostic value for colorectal cancer(CRC),and the positive significance of a variety of tumor markers is more significant.To compare the diagnostic value of Hsp90α,CEA and CA-199 in colorectal cancer.Method From June 2015 to June 2018,150 inpatients with colorectal cancer diagnosed by colonoscopy and postoperative pathology were selected,and 108 cases of high-risk adenoma of colorectal cancer were confirmed by pathology.A total of 75 patients who came to the health examination center of our hospital were randomly selected to detect the levels of heat shock protein 90α(Hsp90 α),carcinoembryonic antigen(CEA)and carbohydrate antigen(CA-199),and to detect the performance of early,middle and advanced colorectal cancer,high-risk adenoma of colorectal cancer and physical examination center.Before the completion of colonoscopy,all patients were tested for one or more tumor markers,and the data of patient name,sex,age,diagnosis,tumor marker content and so on were collected and summarized into excel table.The sensitivity and specificity of three tumor markers were analyzed by Spss24.0software,and the contents of tumor markers in each group were calculated.If the normal distribution is satisfied,the mean ±standard deviation is used,and the t-test oftwo independent samples is used for the comparison between the study groups;if the normal distribution is not satisfied,the median is used for statistics,and the nonparametric test is used to compare the differences between the groups.To compare the diagnostic value of the two methods in the staging of colorectal cancer and high-risk adenoma of colorectal cancer.The receiver operating characteristic curve((ROC))was used to compare the diagnostic effects of three tumor markers on early colorectal cancer.In addition,the expression of tumor markers in each group was analyzed by sex,age,pathological classification,lymph node metastasis and TNM staging.If P<0.05,the difference was significant and statistically significant.Results(1)among the 258 patients who participated in the study,the average age was64(50 cents 75)years old,and there were 150 cases of colorectal cancer,including 30 patients with early colorectal cancer and 108 patients diagnosed as high-risk adenoma of large intestine according to the diagnostic criteria;and 75 patients randomly selected from the health examination center of our hospital to calculate the expression of these three tumor markers in each group.(2)The contents of HSP90α,CEA and CA199 in middle and late stage were significantly higher than those in early stage,high risk adenoma and physical examination(P <0.05).The average content of patients with high-risk adenoma and early colorectal cancer was higher than that of healthy subjects,but the difference was not significant(P>0.05).The average level of early colorectal cancer was slightly higher than that of high-risk adenoma,but there was no statistical significance(P>0.05).The average level of early colorectal cancer was significantly lower than that of advanced colorectal cancer.(3)The positive rates of combined detection of three tumor markers in early colorectal cancer and middle and advanced colorectal cancer were significantly higher than those in healthy controls(P<0.05).When each tumor marker was detected alone,the positive rate of HSP90 a was higher than that of CEA and CA199,and the positive rate ofcombined detection was higher than that of single detection.The positive rate of tumor markers in high-risk adenoma group was not significantly different from that in physical examination(P >0.05),but was significantly lower than that in middle and advanced colorectal cancer(P<0.05).(4)the ROC curve was used to further compare the diagnostic efficacy of HSP90α,CEA and CA199 in the early diagnosis of colorectal cancer.The areas under the ROC curve were calculated respectively,and the diagnostic efficacy of various detection methods for early colorectal cancer was compared.According to the results of Table 5,the diagnostic efficiency of HSP90 α alone is the highest than that of CEA and CA199,and the area of HSP90 α + CEA+CA199 is the largest and close to the upper left corner of ROC curve,which also verifies that the combined detection of tumor markers is the best in the diagnosis of early colorectal cancer.(5)Multivariate logstic regression analysis of HSP90 α,CEA and CA199 in all included patients with colorectal cancer.The statistical results showed that the expression of HSP90 α,CEA and CA199 in colorectal cancer had no significant correlation with age and sex,but was related to pathological differentiation.The content of middle and low differentiation was significantly increased,and when lymph node metastasis occurred,the level of each marker also increased significantly,and it was also correlated with TNM stage.The later the stage,the higher the marker content,the more significant the difference.It was statistically significant(P<0.05).Conclusion HSP90 α,as a new tumor marker,has good sensitivity and specificity in colorectal cancer,and can be combined with other commonly used clinical tumor markers.It can be used in the diagnosis and prognosis of colorectal cancer,which is worthy of clinical promotion. |
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