目的

分析结直肠癌（CRC）早期筛查的实验室检测策略及临床价值。

方法

回顾性分析2021年1月至2024年12月门头沟中医医院和门头沟区医院收治的300例结直肠癌患者（结直肠癌组）及100例健康对照者（对照组）的实验室检测数据，采用SPSS 23.0处理数据。癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、血小板-淋巴细胞比值（PLR）和中性粒细胞-淋巴细胞比值（NLR）等计量资料以（）表示，组间比较采用独立样本t检验；计数资料用百分比表示，采用χ²检验。P<0.05为差异具有统计学意义。

结果

结直肠癌组粪便潜血试验（FOBT）的阳性率为85.3%，对照组为11.0%， 差异有统计学意义（P<0.05），CEA、CA19-9水平及PLR、NLR值均显著高于对照组（P<0.001）；粪便潜血试验（FOBT）、肿瘤标志物（CEA、CA19-9）及全身炎症反应指标（PLR、NLR）联合检测的敏感性达92.2%，特异性达88.5%（AUC=0.933），显著优于单项检测（P<0.05）。

结论

实验室联合检测（FOBT+肿瘤标志物+炎症指标）可显著提升结直肠癌筛查效能。

Objective

To analyze the laboratory detection strategies and clinical value for the early screening of colorectal cancer (CRC).

Methods

The laboratory detection data of 300 patients with colorectal cancer (colorectal cancer group) admitted to Mentougou Traditional Chinese Medicine Hospital and Mentougou District Hospital from January 2021 to December 2024 and 100 healthy controls (control group) were retrospectively analyzed. The data were processed using SPSS 23.0. Measurement data such as carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), platelet-to-lymphocyte ratio (PLR),and neutrophil-to-lymphocyte ratio (NLR) were expressed as (), and the independent sample t test was used for comparison between groups; Enumeration data were expressed as percentages, and the chi-square test was used. A P value < 0.05 was considered statistically significant.

Results

The positive rate of fecal occult blood test (FOBT) in the colorectal cancer group was 85.3%, and that in the control group was 11.0%, with a statistically significant difference (P<0.05). The levels of CEA and CA19-9, as well as the values of PLR and NLR, were significantly higher than those in the control group (P<0.001); The combined detection of fecal occult blood test (FOBT), tumor markers (CEA, CA19-9), and systemic inflammatory response indicators (PLR,NLR) had a sensitivity of 92.2% and a specificity of 88.5% (AUC=0.933), which was significantly better than single-item detection (P<0.05).

Conclusion

The combined laboratory detection (FOBT + tumor markers +inflammatory indicators) can significantly improve the screening efficiency of colorectal cancer.