Combined Detection Of Tumor Markers、FOBT And FH In Predicting Carcinogenesis Of Colorectal Tubular Adenoma

Objective: In this study,we intend to compare the stability of colorectal epithelial cells FH、FOBT、CEA、CA724 and CA199 levels in normal people and colorectal tubular adenoma polyp patients with combined detection,and use multivariate logistic regression analysis to explore the predictive value of the above related indicators in the diagnosis of colorectal tubular adenoma polyp carcinogenesis,so as to provide a non-invasive and easy-to-realize method for predicting colorectal tubular adenoma polyp cancer.Methods: The 248 patients were divided into polyp-free group,inflammatory or hyperplastic polyp group,tubular adenoma with low-grade intraepithelial neoplasia,and tubular adenoma with high-grade intraepithelial neoplasia.The content levels of free ferrous protoporphyrin(FH),fecal FOBT,serum carcinoembryonic antigen(CEA),glycan chain antigen 724(CA724)and sugar chain antigen 199(CA199)were compared in different groups of patients,and the relationship between the levels of individual indexes and the occurrence and carcinogenesis of different adenomas was first discussed.Multivariate unconditional logistic regression analysis was further used for the indicators with significant differences,and the regression equation was established,and the best cut-off value for predicting CAP carcinogenesis by jointly detecting related variables was calculated.Results: Tubular adenomatous polyps(early cancer)with high-grade neoplasia were different in age,gender,smoking,drinking history,number of polyps,fecal occult blood,FH and CEA compared with tubular adenomatous polyps with hyperplasia and inflammatory polyps and low-grade neoplasia,and further regression analysis was carried out,and it was found that the factors related to adenomatous polyp carcinogenesis were polyp number,fecal occult blood,FH,AUC=0.754,95% CI was 0.656～0.851,P<0.05.The best cut-off value was 0.346,the sensitivity was 77.7%,the specificity was 64.0%,and the maximum approximate index was 0.411;the area under the curve was between 0.7-0.9,which had medium diagnostic value,and the progressive SIG < 0.05,indicating that the diagnostic system was effective.At the same time,we found that for healthy people,advanced age,multiple polyps and positive FH、FOBT and CEA are risk factors for adenomatous polyps.Conclusion: Advanced age,multiple polyps,and positive FH 、FOBT and CEA are risk factors for adenomatous polyps.Multiple polyps,positive fecal occult blood,and positive FH are early predictors of carcinogenesis of tubular adenomatous polyps.This study provides a non-invasive,simple and easy screening method for the occurrence of colorectal tubular adenomous polyps and the prediction of carcinogenesis of tubular adenoma polyps.