Abstract
Objective To investigate the clinical significance of fecal occult blood test(FOBT),carcino-embryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)in the early screening of colorectal cancer(CRC).Methods Clinical data of 206 participants admitted to our hospital from April 2022 to A-pril 2024 were retrospectively analyzed.Participants were divided into three groups:CRC group(86 ca-ses),colorectal polyp group(CRP,70 cases),and healthy control group(50 cases).All subjects underwent FOBT,and serum levels of CEA and CA19-9 were measured.Results The positive rate of FOBT was 65.12％(56/86)in the CRC group,64.29％(45/70)in the CRP group and 0 in the healthy control group.There was no significant difference in FOBT between the CRC group and the CRP group(P＞0.05).The positive rate of FOBT in both groups was significantly higher than that in the healthy control group(P＜0.05).The positive rates of CEA and CA19-9 were 66.28％(57/86)and 76.74％(66/86)in the CRC group,20.00％(14/70)and 12.86％(9/70)in the CRP group,and 10.00％(5/50)and 14.00％(7/50)in the healthy control group,respectively.The positive rates of CEA and CA19-9 in the CRC group were high-er than those in the CRP group and the healthy group(P＜0.05).The sensitivity of FOBT to CRC was 65.12％,specificity 62.50％,false positive rate 44.55％,false negative rate 28.57％and accuracy 63.59％.CEA was 66.28％,84.17％,25.00％,22.31％and 76.70％,respectively.CA19-9 were 76.74％,86.67％,19.51％,16.13％and 82.52％,respectively.FOBT+CEA were 72.09％,58.33％,44.64％,25.53％and 64.08％,respectively.FOBT+CA19-9 were 82.56％,60.83％,39.83％,17.05％and 69.90％,respective-ly.CEA+CA19-9 were 80.23％,66.67％,36.70％,17.52％and 72.33％,respectively.FOBT+CEA+CA19-9 were 87.21％,55.83％,41.41％,14.10％and 68.93％,respectively.ROC curve analysis showed that the AUC of FOBT,CEA and CA19-9 for CRC screening was 0.543,0.657 and 0.704,respectively,and the AUC of CEA and CA19-9 was greater than that of FOBT(z were 3.642 and 4.572,P＜0.001).There was no significant difference in AUC between CEA and CA19-9(P＞0.05).The AUC of FOBT+CEA,FOBT+CA19-9,CEA+CA19-9 and FOBT+CEA+CA19-9 screening for CRC were 0.692,0.698,0.733 and 0.891,respectively,and the AUC of FOBT+CEA+CA19-9 was greater than that of other com-bined schemes(P＜0.001).There was no significant difference in the pairwise comparison of AUC among other combined schemes(P＞0.05).Conclusion FOBT and serum CEA and CA19-9 exhibit distinct values in early CRC screening.Single-marker approaches show limited sensitivity,while the triple combina-tion achieves the highest screening efficacy with improved sensitivity.关键词
结直肠癌/粪便潜血试验/癌胚抗原/糖类抗原19-9/早期筛查Key words
Colorectal cancer/Fecal occult blood test/Carcinoembryonic antigen/Carbohydrate antigen 19-9/Early screening
