Significance Of Combined Determination Of Factors (CRP-SAA-CEA) For Colon Cancer Diagnosis

ObjectiveColon cancer is one of the most common tumor of digestive system. Early diagnosisis the key to improve the curative effect and prognosis. Therefore, looking for someconclusive, sensitive method to improve the rate of early diagnosis of colorectal cancer isvery important. At present, with the development of molecular markers, more and moretumor markers for clinical application. Previous studies have confirmed that CEA is thespectrum of a tumor marker; serum C reactive protein (C-reactive, protein, CRP) as anacute phase protein CRP plays an important role in the acute injury and infection; inaddition the expression level of inflammatory medium serum amyloid A (serum amyloid Aprotein, SAA) may be closely related to the occurrence of tumor. In this study, in order toevaluate the clinical value of SAA, CRP and CEA, we detected their expression levels inpatients with colon cancer and we also analysis the relativity of SAA and CRP, as thetumour markers combined CEA for early diagnosis.MethodsSelect81cases of colon cancers who were received surgical resection in the Taiancentral Hospital during from Dec.2011to Dec.2012, of the patients which39were maleand other42were female. The median age was57.84years old (range from18to81).（Allthe samples were verification by pathology，Selection criteria for all specimens wereconfirmed by histopathology, and for the first time found. Exclusion criteria: infection orsigns of infection occurred within1months after admission with inflammatory disease orthose with other chronic diseases; immune system diseases; acquisition of received tumorauxiliary treatment. In this study, collected the serum samples of patients with colon cancerduring the past year.outpatient health checkup staff was set to the normal control group,Other indicators were need to exclude the presence of a neoplastic disease).1. The concentration of SAA and CRP in the serum was detected by ELISA(electrophoretic mobility shift assay), and the concentration of CEA were measuredby electrochemical luminescence.2. Statistical Methods: Using Microsoft Excel2007to establish the database, allstatistical analyses were used SPSS17.0and PEMS3.0statistical software,and the cutoffvalue of CRP、SAA was obtained by ROC curve in the serum. Diagnostic values of thesethree markers and combined detection(CEA-SAA、 CEA-CRP、 SAA-CRP与CEA-SAA-CRP) were analyzed by Epidemiology.Results1. The serum level of CRP and CEA in colon cancers were higher than in the healthygroup which were significant difference (P﹤0.05).2. The serum level of CRP and CEA in colon cancers represent no significantdifference in different gender (P＞0.05), the serum level of SAA in colon cancers offemale was significantly higher than that of male.3. In different age, the serum level of CRP and SAA in patients with colon cancerswas no statistical difference (P＞0.05), but the level of CEA in no less than60years oldwas Significantly higher than the less than60years old, which had a statisticallysignificant (P﹤0.05).4. The level of serum CRP in patients with colon cancers invaded into the serosa wassignificantly higher than that invaded into the muscular layer, and the difference wasstatistically significant (P﹤0.05). but the level of serum SAA and CEA was no significantdifference(P＞0.05).5. The serum level of CEA、SAA was higher in the colon cancers with tumor diameter≥5cm than that with tumor diameter﹤5cm however they represent no remarkabledifference (P＞0.05)；The serum level of CRP was significantly higher in the colon cancerswith tumor diameter≥5cm than that with tumor diameter﹤5cm, and they representsignificant difference (P﹤0.05).6. While the cutoff values of SAA is11.225mg/L, the sensitivity and specificity of thecolon cancers were90.10%and81.20%, respectively; when the CRP cutoff number is2.5mg/L, the sensitivity and specificity of the colon cancers were81.50%and75.30%,respectively; when obtained the cutoff values of CEA is3.4ng/mL, the sensitivity andspecificity of the colon cancers were70.40%and88.90%.7. Not only the detection rate of colon cancer rely on SAA but also the CRP was higher than CEA, and the combined determination had much more clinical value thansingle one.8. Combined determination of CRP、CEA and SAA showed the highest sensitivity(98.77%), and its specificity, Youden，Positive likelihood ratio, negative likelihood ratio,positive predictive value (PPV) and negative predictive value (NPV) were50.09%、0.52、2.11、0.02、67.80%、97.73%, respectively.9. Through the the line×list χ2test of association to related analytical method showsthe CRP and CEA has no remarkerable relevance(P＞0.05); the SAA and the CEA also hasno significant relativity(P＞0.05).Conclusion1. The concentration of CRP、SAA and CEA from serum in colon cancers were higherthan that in the healthy group.2. CRP、SAA and CEA could be regarded as the serum biomarkers for the coloncancer, which take part in the germination of colon cancers.3. CRP, SAA, CEA in serum could be used as diagnostic indicators of colon cancersingly；the combined determination had more clinical value than single and combineddetermination of CRP-SAA-CEA showed the highest clinical value.4. Both CRP-CEA and SAA-CEA in serum for colon cancer represent no Correlationwhich indicated that SAA, CRP were not substitutes for CEA as clinical indicators andthey play different roles.