The Relationship Between Serum Hcy,CEA,CA199 Levels And The Occurrence And Development Of Colorectal Tumors

Objective:To investigate the changes of serum homocysteine(Hcy),carcinoembryonic antigen(CEA),carbohydrate antigen199(CA199)levels in patients with colorectal tumors,and to explore the correlation between serum Hcy,CEA and CA199 levels and the occurrence and development of colorectal tumors,and the diagnostic value of the serum levels of Hcy and CEA in colorectal tumors.Methods:A total of 108 patients with colorectal tumors(including 36 patients with colorectal cancer and 72 patients with colorectal adenomatous polyps),31 patients with colorectal hyperplastic polyps and 20 healthy controls,confirmed by colonoscopy and pathology,were admitted to the Second Affiliated Hospital of Anhui Medical University from May 2020 to August 2020.The levels of serum Hcy,CEA and CA199 were measured by enzyme cycling and electrochemiluminescence.To analyze the differences of serum Hcy,CEA and CA199 levels among the three groups,and to further analyze the differences of serum Hcy,CEA and CA199 levels in patients with different pathological types,sex,age,colorectal polyp size and number of colorectal polyps.Binary logistic regression model was used to explore the risk factors of colorectal tumors.At the same time,the area under the curve(AUC)and the optimal critical value of serum Hcy and CEA levels in independent and combined diagnosis of colorectal tumors were measured by receiver working characteristic curve(ROC).Results:1.Serum Hcy and CEA levels in colorectal tumor group were higher than those in hyperplastic polyps and healthy controls [Hcy: 13.56±3.87 umol/l VS.11.02±2.71umol/l VS.10.68±1.91 umol/l,P<0.01;CEA: 2.56(1.51-4.01)ng/ml VS.1.69(0.99-2.87)ng/ml,P<0.05;2.56(1.51-4.01)ng/ml VS.1.26(0.92-2.03)ng/ml,P<0.01],No significant difference was found in serum CA199 levels among the colorectal tumors group,hyperplastic polyps and healthy control group(P>0.05).2.In further subgroup analysis,the levels of serum Hcy in colorectal cancer group and high-risk adenomatous polyp group were higher than those in hyperplastic polyp group and healthy control group(P < 0.01).The serum CEA level of colorectal cancer group was higher than that of hypertrophic polyp group and healthy control group(P <0.01).The serum CEA level in high-risk adenomatous polyp group was higher than that in healthy control group(P < 0.05);In people under 50 years old,the level of serum Hcy in high-risk adenomatous polyps group was higher than that in hyperplastic polyps group(P < 0.01)and healthy control group(P < 0.05),but there was no significant difference in serum CEA and CA199 level among the four groups(P>0.05);In the group of ≥ 50 years old,the levels of serum Hcy and CEA in colorectal cancer group were higher than those in hyperplastic polyp group and healthy control group(P< 0.01),and the level of serum Hcy in high-risk adenomatous polyp group was higher than that in healthy control group(P < 0.05),serum CEA level of high-risk adenomatous polyp group was not significantly different from that of hypertrophic polyp group and healthy control group(P>0.05),there was no significant difference in serum CA199 level among the five groups(P>0.05);In male population,the level of serum Hcy in colorectal cancer group was higher than that in hyperplastic polyp group(P < 0.01)and healthy control group(P < 0.05),the serum Hcy level of high-risk adenomatous polyp group was higher than that of hypertrophic polyp group(P<0.05),but there was no significant difference in serum CEA and CA199 level between groups;In female population,serum CEA level of colorectal cancer group was higher than that of low-risk adenomatous polyp group,hyperplastic polyp group and healthy control group(P<0.01),serum CEA level of high-risk adenomatous polyp group was not different from that of hyperplastic polyp group and healthy control group(P > 0.05).Serum Hcy and CA199 levels were not different between the groups;Serum Hcy and CEA levels in polyp diameter ≥ 1cm group were higher than those in healthy control group(P < 0.05),but there was no significant difference in serum CA199 levels among the three groups(P > 0.05);The serum Hcy level in multiple polyps group was higher than that in single polyp group(P < 0.05)and healthy control group(P < 0.01),and the serum CEA level in multiple polyps group was higher than that in healthy control group(P < 0.05).There was no difference in serum CA199 level between groups(P>0.05).3.Multivariate logistic multiple regression analysis showed that serum Hcy level(OR=1.176,95%CI: 1.013-1.365)and tumor diameter ≥1cm(OR=4.829,95%CI:2.117-11.015)were independent risk factors for colorectal tumors.And the serum CEA level(OR=1.355,95%CI: 1.070-1.715)and age(OR=1.078,95%CI: 1.030-1.128)were independent risk factors for colorectal cancer.4.The AUC of the ROC curve for the diagnosis of colorectal tumor at serum Hcy level was 0.705,with a cut-off value of 11.3 umol/l,a sensitivity of 69.44% and a specificity of 64.71%.The AUC value of serum CEA level in the diagnosis of colorectal tumor was 0.691,the cut-off value was 1.85 ng/m L,the sensitivity was67.31%,and the specificity was 66.67%.The AUC value of serum Hcy combined with CEA in the diagnosis of colorectal tumor was higher than that of single detection,the value was 0.750,the sensitivity was 66.35%,and the specificity was 76.47%.For colorectal cancer,the AUC value of serum Hcy level for diagnosis of colorectal cancer was 0.646,the cut-off value was 11.2 umol/l,the sensitivity was 80.56%,and the specificity was 44.72%.The AUC value of serum CEA level in the diagnosis of colorectal cancer was 0.704,the cut-off value was 4.35 ng/m L,the sensitivity was44.44%,and the specificity increased to 91.60%.The AUC value of serum Hcy combined with CEA in the diagnosis of colorectal cancer was the highest,which was0.741,the sensitivity was 50.00%,and the specificity was 88.24%.Conclusions:1.The levels of serum Hcy and CEA in patients with colorectal tumor were higher than those in patients with hyperplastic polyps and healthy controls.No difference was found in serum CA199 levels among patients with colorectal cancer,patients with hyperplastic polyps and healthy controls.2.Serum Hcy and CEA levels were correlated with the occurrence and development of colorectal tumors,and were also related to age and gender.Serum Hcy level was a related factor for colorectal cancer risk,and serum CEA level was a related factor for colorectal cancer risk.Serum CA199 level was not significantly associated with the occurrence and development of colorectal tumors.In patients with colorectal polyps,serum Hcy and CEA levels were correlated with the size and number of polyps.3.Serum Hcy combined with CEA detection has certain value in the diagnosis of colorectal tumors.