| ObjectiveTumor Marker detection is an auxiliary diagnostic method for clinical diagnosis of tumors,which has high clinical value.However,there are few studies on the detection of tumor markers in precancerous lesions such as Adenomatous Polyp.In addition,it has been known in previous experiments that tumors can have a certain impact on Inflammatory Index and coagulation function,but the effect of adenomatous polyps on inflammatory index and coagulation function has not been definitively concluded.In addition,previous experiments have confirmed that gastrointestinal polyps are more common in middle-aged and elderly people.The older the age,the higher the risk of adenoma and cancer.The aim of this study is to explore the diagnostic value of digestive system tumor markers,coagulation markers and inflammatory markers for adenomatous polyps in elderly men.Methods1.The preoperative and postoperative examination results of elderly male patients who underwent endoscopy in the General Hospital of Northern Theater Command from January 2017 to December 2021 were retrospectively collected.Among them,111 patients with adenomatous polyps as adenomatous polyps group(group A),54 patients with non-adenomatous polyps as nonadenomatous polyps group(group B),81 patients without polyps as healthy control group(group C),the results of reexamination of patients with adenomatous polyps after clamp as group D,and the results of reexamination of patients with non-adenomatous polyps as group E were compared between the groups.The differences of AFP,CA125,CA199,white blood cell(WBC),total neutrophil(NEU),red blood cell(HGB),platelet(PLT),PT,partial thromboplastin time(APTT),fibrinogen(FIB)and high-sensitivity C-reactive protein(h CRP)were analyzed.2.Receiver Operator Characteristic Curve(ROC curve)was used to analyze the difference and value of tumor markers,inflammatory indicators and coagulation related indicators that were significantly different between adenomatous polyps group and non-adenomatous polyps group and healthy group for single prediction and combined diagnosis of adenomatous polyps.3.Linear regression analysis was used to analyze the effect of the number and size of polyps on tumor markers CEA,AFP,CA125,CA199 and coagulation related index PT in adenomatous polyps group.Results1.CEA and CA199 in adenomatous polyps group were significantly higher than those in non-adenomatous polyps group,healthy people group and adenomatous polyps after clamp removal(P<0.05),AFP and CA125 were significantly higher than those in healthy group and adenomatous polyps after clamp removal(P<0.05).PT was significantly higher than that of nonadenomatous polyps group and healthy people group(P<0.05),while h CRP was significantly lower than that of non-adenomatous polyps group.CA125 in non-adenomatous polyps group was significantly higher than that in healthy people group and non-adenomatous polyps after clamp removal(P<0.05),and CEA,AFP,CA199,WBC,PLT,PT and h CRP were all higher than those in nonadenomatous polyps after clamp removal(P<0.05).The values of CEA and CA199 in adenomatous polyps after clamp removal were significantly higher than those in non-adenomatous polyps after clamp removal(P<0.05).2.CEA,AFP,CA125,CA199 and PT in adenomatous polyps group were selected for ROC curve analysis.The results showed that CA125 had the highest diagnostic efficiency with an AUC of 0.734,a sensitivity of 63.1%,and a specificity of 77.8%.The relatively balanced single detection index was CEA,with a sensitivity of 70.3%,a specificity of 70.4%,and an AUC of 0.731.CEA+CA125 had the highest test efficiency in the combined detection of the two indicators,with an AUC of 0.768,a sensitivity of 67.6%,and a specificity of80.2%.CEA+CA125+AFP had the highest AUC(0.777),sensitivity(78.4%)and specificity(67.9%).CEA+AFP+CA125+PT had the highest AUC(0.785),sensitivity(78.4%)and specificity(67.9%)among the four combined tests.The combined detection of five tests had the highest diagnostic efficacy among single and multiple tests,with an AUC of 0.787,a sensitivity of 77.6% and a specificity of 69.1%.3.Linear regression analysis showed that the diameter of adenomatous polyps was positively correlated with CEA,AFP,CA125,CA199 and PT(P<0.05).The number of adenomatous polyps was only positively correlated with CEA,CA125 and PT(P<0.05).Conclusions1.Adenomatous polyps can increase the level of tumor markers in elderly men,and the removal of tumor markers can reduce the level of tumor markers.The increase of PT due to adenomatous polyps is not decreased by the removal of polyps.2.ROC curve analysis showed that CEA,AFP,CA125,CA199 and PT could predict the diagnosis of adenomatous polyps in elderly men,and the combined detection of the five indicators had the highest test efficiency.3.Linear analysis of CEA,AFP,CA125,CA199,PT and the size and number of adenomatous polyps showed that each index was positively correlated with the size of polyps,while only CEA,CA125 and PT were positively correlated with the number of polyps. |
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