| Objective: To investigate the expression and diagnostic value of plasma D-dimer, serum carcinoembryonic antigen(CEA), carbohydrate antigen 19-9(CA19-9) and carbohydrate antigen 72-4(CA72-4) in colorectal cancer, and whether the abnormalities of blood coagulation and fibrinolytic system occur in the patients with colorectal cancer.Methods: 76 patients with colorectal cancer were selectedin our hospital, and 60 hospitalized non-tumor patients cases as control from June, 2013 to January, 2015.The patients from both groups were tested for plasma D-dimer, serum CEA, CA19-9 and CA72-4 level before treatment, which were assessed by turbidimetric immunoassay and chemiluminescence.The data was analyzed by SPASS22.0.Results:1.In colorectal cancer patients, 38 out of 76 were increasing with D-dimer, and the positive rate was 50%; 26 out of 76, 17 out of 76 and 25 out of 76 were increasing with the three tumor markers of CEA, CA19-9, CA72-4, and the positive rate were 34.2%, 22.4%, 32.9% respectively. The positive rate of D-dimer was higher than that of CEA, CA19-9 and CA72-4(P < 0.05).2.The comparison of D-dimer and 3 kinds of tumor markers in infected and control group:The levels of D-dimer,CEA,CA19-9 and CA72-4 in colorectal cancer group were higher than that in control group,and it was significant difference between colorectal cancer group and control group(P < 0.001).3. The relationship between D-dimer and 3 kinds of tumor markers in clinical and pathological elements in colorectal cancer patients:The levels of D-dimer and 3 kinds of tumor markers in III+IV stage were significant higher than that of I+II stage in colorectal cancer(P<0.05); The group of lymph node metastasis or distant metastasis was significant higher than the group of non lymph node metastasis or non distant metastasis(P<0.05); The expression of the D-dimer and 3 kinds of tumor markers had no statistical difference in different age and gender(P>0.05).4.The correlation of plasma D-dimer and 3 kinds of tumor markers in colorectal cancer patients:The level of D-dimer was consilient correlated with CEA, CA19-9, CA72-4 in colorectal cancer patients.5.When diagnosing colorectal cancer,the AUC of D-dimer was 0.812, and the AUC of CEA,CA19-9,CA 72-4 were 0.748,0.702,0.672.6.The sensitivity and specificity of D-dimer and 3 kinds of tumor markers in colorectal cancer patients:The sensitivity of D-dimer was highest in single detection, followed by CEA, CA72-4, CA19-9. However, the specificity of D-dimer was minimum in the four markers.Though the sensitivity was also low in the triple or quadruple test, it was higher than the single detection.Conclusion:1.The expression of the D-dimer, CEA, CA19-9 and CA72-4 was higher in patients with colorectal cancer.The patients with colorectal cancer exist thrombophilia.The level of D-dimer, CEA, CA19-9 and CA72-4 may be relevant with the TNM stage of colorectal cancer, the status of lymph node,distant metastasis and the number of metastatic lymph nodes, but the different in age and sex has no statistical levels.Later is the stage, there are lymph node metastasis, distant metastasis, more lymph node metastasis, higher is the level of D-dimer, CEA, CA19-9 and CA72-4.3.The level of D-dimer wasconsilient correlated with CEA, CA19-9, CA72-4 in colorectal cancer patients.4.It is beneficial to monitor the level of D-dimer,CEA, CA19-9 and CA72-4 for understanding the progression dynamic of patients with colorectal cancer.5.D-dimer, CEA, CA19-9and CA72-4 could be used as one of the important auxiliary diagnosis, and the joint detection could improve the sensitivity, although it is not final diagnosis to confirmed colorectal cancer.6.It is easy for malignant tumors to emerge hypercoagulable state. Monitoring the level of D-dimer dynamicly, comprehending the state of coagulation and fibrinolysis in patients and an early intervention may reduce the incidence of thrombotic complications. |
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