Study Of CK,CK-MB/CK And LDH In Diagnosis And Prognosis Of Colorectal Cancer

Objective: to analyze the differences of serum creatine kinase(Creatine Kinase,CK),creatine kinase isoenzyme-MB subtype(Creatine Kinase-MB,CK-MB,creatine kinase isoenzyme-MB subtype than creatine kinase(CK-MB/CK)and lactate dehydrogenase(Lactate Dehydrogenase,LDH)in patients with colorectal cancer(Colorectal Cancer,CRC)and colorectal benign diseases,and to explore their clinical value in the diagnosis and prognosis of colorectal benign and malignant tumors.And then guide clinical practice.Methods: 302 patients with CRC and 74 patients with colorectal adenoma or polyp diagnosed by pathology in the affiliated Cancer Hospital of Guangxi Medical University were collected.The age,sex,CK,CK-MB,LDH,carcinoembryonic antigen(Carcinoembryonic Antigen,CEA),carbohydrate antigen 199CA199)serological indexes were collected.CK-MB/CK,was calculated and the tumor location,differentiation,TNM stage,clinical stage and survival time of CRC patients were recorded.Mann-Whitney U,Bonferroni correction test,T test and chi-square test were used to analyze the differences of clinical features,CK,CK-MB/CK,LDH,CEA and CA199 serological indexes between CRC and colorectal benign disease group,and to analyze the relationship between serological indexes and clinicopathological features in CRC group.Kaplan-Meier survival curve and Log-rank test were used to compare the overall survival rate among groups with different levels of serological indexes in CRC group.Cox regression model was used to analyze the effects of different serological indexes and clinicopathological characteristics on overall survival in CRC group.The receiver working characteristic curve((Receiver operating characteristic curve,ROC)was used to draw the area under the curve of different serological indexes((Area under the curve,AUC),and the diagnostic efficacy of each serological index for CRC was analyzed.Results:1.the serum CK level in CRC group(58.75112.00)was significantly lower than that in benign colorectal disease group(66156.50).The CK-MB/CK level in 120.00(0.07)was higher than that in benign colorectal disease group(0.06).The difference was statistically significant(P < 0.05).The levels of CEA and CA199 in CRC group were significantly higher than those in benign colorectal disease group.There was no significant difference in LDH between the two groups.2.In CRC group,serum CK level was lower in female,tumor site was in right large intestine,tumor stage M1 and IV was lower,CK-MB/CK was higher in right large intestine,tumor M1 and IV stage,serum LDH was higher in tumor N2,M1,IV stage,the difference was statistically significant.There was no significant difference in serum CK,CK-MB/CK and LDH levels among different differentiation degrees.3.The results of ROC curve analysis showed that the AUC of CK,CK-MB/CK,CEA and CA199 were 0.629,0.596,0.636 and 0.589 respectively.The AUC of CEA combined with CA199 was 0.646,and the maximum AUC of CEA combined with CK was 0.703,the sensitivity was 67.2%,and the specificity was 65%,which was statistically significant.LDH has no ability to diagnose colorectal cancer.4.The results of Kaplan-Meier survival curve and Log-rank test showed that the mortality of patients with CK-MB/CK > 0.335,LDH > 227U/L,CEA >5ng/ml,CA199 > 37ng/ml and CK < 74.5U/L in CRC group was significantly higher.5.COX regression analysis showed that N stage(HR4.27,95%CI:2.038-8.946),M stage(HR5.093,95%CI: 2.769-9.369),differentiation degree(HR0.357,95%CI: 0.18-0.706)and serum LDH level(HR1.002,95%CI: 1.001-1.004)were independent risk factors for prognosis of CRC patients.Conclusion: serum CK,CK-MB/CK,CEA and CA199 have the ability to diagnose CRC,but the diagnostic efficiency is low,and the combination of multiple indexes can improve the diagnostic efficiency.CK and CK-MB/CK are different in left and right colorectal cancer,suggesting that left and right colorectal cancer may be heterogeneous.the later the stage of CRC tumor,the higher the CK-MB/CK and LDH,the lower the CK and the lower the survival rate.In CRC patients,NM stage,differentiation degree and serum LDH level are independent risk factors affecting the prognosis of CRC patients.