The Correlation Of Preoperative CEA,CA199,NLR And PLR With The Diagnosis And Clinicopathological Features Of Colorectal Cancer

Objective: To investigate the correlation of preoperative CEA,CA199,NLR and PLR with the diagnosis and clinicopathological features of CRC.Methods: Our department were retrospectively analyzed from January 2015 to January 2018,after the surgical treatment of CRC patients(180 cases)as the observation group,and in the same period in our hospital for physical examination of healthy people(100 cases)as control group,collect observation group and control group in preoperative serum CEA,CA199,NLR and level of PLR and postoperative pathology features of CRC,and the corresponding statistical analysis.Results: 1.There were no significant differences in the history of alcohol consumption,smoking,diabetes,hypertension,gender and age between the CRC group and the control group(all P>0.05).The levels of plasma CEA,CA199,NLR and PLR in colorectal cancer group were significantly higher than those in control group,and the differences were statistically significant(all P<0.001).2.The levels of plasma CEA,CA199,NLR and PLR increased with lymph node metastasis,tumor invasion depth and TNM stage(stage I-III)(mean R>0.2),and the difference was statistically significant(all P<0.001).Preoperative plasma CEA,CA199,NLR and PLR levels increased with the decrease of tumor differentiation degree(all R<-0.2),and the differences were statistically significant(all P<0.001).3.The area under the ROC curve of CEA in the diagnosis of colorectal cancer was 0.813(P<0.001),indicating that serum CEA had a certain accuracy in the diagnosis of colorectal cancer.The optimal diagnostic threshold of CEA was 4.55ng/ml,at which the sensitivity and specificity of CEA in the diagnosis of colorectal cancer were 62.8% and 100%.The area under the ROC curve of CA199 for the diagnosis of colorectal cancer was 0.778(P<0.001),indicating that plasma CA199 had a certain accuracy in colorectal cancer screening.At the same time,the optimal diagnostic threshold of CA199 was 22.39U/mL,and the sensitivity and specificity of CA199 in the diagnosis of colorectal cancer were 61.7% and 92.7%.The area under the ROC curve of NLR for the diagnosis of colorectal cancer was 0.768(P<0.001),indicating a certain accuracy of plasma NLR in colorectal cancer screening.At the same time,the optimal diagnostic threshold of NLR was 3.22,and the sensitivity and specificity of NLR in the diagnosis of colorectal cancer were 59.4% and 98.2% respectively.The area under the ROC curve of PLR for the diagnosis of colorectal cancer was 0.76(P<0.001),indicating a certain accuracy of plasma PLR in colorectal cancer screening.At the same time,the optimal diagnostic threshold of NLR was 188.215,and the sensitivity and specificity of NLR in the diagnosis of colorectal cancer were 55% and 94.5%.The area under the ROC curve of CEA+CA199+NLR+PLR in the diagnosis of colorectal cancer was 0.807(P<0.001),indicating that serum CEA+CA199+NLR+PLR had a certain accuracy in the diagnosis of colorectal cancer.The optimal diagnostic threshold of CEA+CA199+NLR+PLR was 0.705,and the sensitivity and specificity of CEA+CA199+NLR+PLR in the combined diagnosis of colorectal cancer was 62.8% and 99.1%,indicating that the combined diagnosis of CEA+CA199+NLR+PLR had a certain accuracy,and the combined detection could improve the diagnostic accuracy.4.There were no statistically significant differences in preoperative plasma CEA,CA199,NLR,age,sex and primary site of tumor(P>0.05).Conclusions: 1.The preoperative levels of CEA,CA199,NLR and PLR in the colorectal cancer group were significantly higher than those in the healthy control group.2.The preoperative levels of CEA,CA199,NLR and PLR in colorectal cancer were closely related to the clinicopathological characteristics of the tumor.With the occurrence of lymph node metastasis,the increase of tumor invasion depth,and the increase of TNM stage(stage I-III),the preoperative levels of plasma CEA,CA199,NLR and PLR were also gradually increased.Preoperative plasma levels of CEA,CA199,NLR and PLR increased with the decrease of tumor differentiation.3.Preoperative combination of CEA,CA199,NLR and PLR can improve the accuracy of detection of colorectal cancer.