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目的:探讨术前CT联合血清癌胚抗原(CEA)在直肠癌临床分期中的应用价值,旨在为直肠癌的早期诊治提供理论参考。方法:回顾性分析了30例直肠癌患者的临床资料,包括术前CT检查,术后血清CEA水平和术后病理结果。术前CEA水平采用ELISA法测定,CT扫描采用64排螺旋CT扫描机进行扫描。结果:本组30例患者术后经病理证实为直肠癌,TNM分期:T1期5例,T2期13例,T3期9例,T41期3例;血清CEA水平在术后病理分期之间存在统计学差异(P<0.05),随着病理分期的增加,血清CEA水平升高;术前经CT检测,临床分期为:T1期3例,T2期12例,T3期12例,T4期3例;术前CT诊断直肠癌T1、T2期敏感性和准确性均较低,CT和血清CEA联合检测在直肠癌T1、T2期诊断中敏感性、特异性和准确性分别为100.0%、83.3%和85.7%,其敏感性与CT诊断相比较有统计学差异(P<0.05)。结论:术前CT和血清CEA联合检测可以提高直肠癌分期诊断的敏感性,对直肠癌的早期诊断和鉴别具有重要的临床价值。
Objective: To investigate the value of preoperative CT combined with serum carcinoembryonic antigen (CEA) in the clinical staging of rectal cancer, and to provide a theoretical reference for the early diagnosis and treatment of rectal cancer. Methods: The clinical data of 30 patients with rectal cancer were analyzed retrospectively, including the preoperative CT examination, postoperative serum CEA level and postoperative pathological results. Preoperative CEA levels were measured by ELISA, CT scan using a 64-slice spiral CT scanner for scanning. Results: Thirty patients in this group were pathologically confirmed as rectal cancer. The TNM stage was 5 cases in stage T1, 13 cases in stage T2, 9 cases in stage T3 and 3 cases in stage T41. Serum CEA levels were found between the postoperative pathological stages (P <0.05). Serum CEA level increased with the increase of pathological stage. Preoperative CT examination showed that the clinical stage was T1 in 3 cases, T2 in 12 cases, T3 in 12 cases, T4 in stage 3 For example, the sensitivity and specificity of preoperative CT in the diagnosis of rectal cancer at stage T1 and T2 were low. The sensitivity, specificity and accuracy of CT and serum CEA in the diagnosis of T1 and T2 stage rectal cancer were 100.0% and 83.3 % And 85.7% respectively. The sensitivity was significantly different from CT diagnosis (P <0.05). Conclusion: Preoperative CT and serum CEA combined detection can improve the sensitivity of staging diagnosis of rectal cancer, which has important clinical value for early diagnosis and differential diagnosis of rectal cancer.