Diagnostic Value Of Serum Fibrin Degradation Product DR-70 Combined With Conventional Tumor Markers In Colorectal Cancer

Objective To study the difference in the expression level of serum DR-70 in colorectal cancer(CRC)group,colorectal benign disease group and control group,to analyze the relationship between the expression of DR-70 and the clinical characteristics of subjects,to compare the diagnostic value of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 15-3(CA15-3),carbohydrate antigen 72-4(CA72-4)and DR-70 for CRC,to explore a best combination for diagnosing CRC.Methods Filtered CRC patients,patients with benign colorectal diseases and healthy people who met the inclusion criteria,and collected clinical parameters,including the subjects’gender,age,lesion location,clinical stage,presence or absence of distant metastasis and so on.The serums of the subjects were collected,the expression levels of DR-70 and conventional tumor markers(CEA,CA125,CA19-9,CA15-3 and CA72-4)were detected by enzyme-linked immunosorbent assay and electrochemiluminescence immunoassay respectively.The differential expression of DR-70 in different groups was compared by SPSS25.0.The relationship between the expression level of DR-70 and clinical parameters(such as age,gender,lesion site,distant metastasis,and clinical stage)was analyzed.The ROC curves of CEA,CA125,CA19-9,CA15-3,CA72-4,DR-70 were drawn by Graphpad Prism8,and the values of these tumor markers in the diagnosis of CRC were compared by the area under the curve,the optimal cut-off value and its corresponding sensitivity and specificity.Calculate the sensitivity,specificity,positive predictive value,and negative predictive value of the single tumor marker,and compare the sensitivity,specificity,positive predictive value,and negative predictive value of the combined detection of multiple serum tumor markers to find the best combination for diagnosing CRC.Results1.The means of CEA,CA125,CA19-9,CA15-3,CA72-4,DR-70 in the CRC group were higher than those in the colorectal benign disease group and the control group,the expression levels of CEA,CA125,CA19-9,CA15-3,and CA72-4 were significantly different among the three groups(P<0.001).The expression level of DR-70 in the CRC group was both significantly different from those in the colorectal benign disease group and in the control group(P<0.001),but there was no significant difference between the colorectal benign disease group and the control group(P=0.7711).2.There were significant differences in the expression level of DR-70 with age,lesion location,clinical stage and distant metastasis(P<0.05),but no significant difference with gender(P=0.932).The positive rate of DR-70 detection in the older age group(age>55 years)(45.0%)was significantly higher than that in the younger age group(age ≤55 years)(13.4%).Comparing CRC patients and patients with benign colorectal diseases,it was found that the positive rate of DR-70 in patients with lesions located in the colon(52.2%)was higher than that in patients with lesions located in the rectum(34.8%).The positive rate of DR-70 in CRC patients with distant metastasis(77.3%)was higher than that in CRC patients without distant metastasis(51.1%);the positive rates of DR-70 in CRC patients with clinical stages Ⅰ,Ⅱ,Ⅲand Ⅳ were 33.3%,50.0%,68.8%and 77.3%,respectively.With the progression of the cancer,the positive rate of DR-70 showed an upward trend.3.Our data showed that the sensitivity of DR-70 was 56.0%,the specificity was 92.9%,the positive predictive value was 86,7%,and the negative predictive value was 71.8%.Among all single tumor marker tests,DR-70 had the highest sensitivity and negative predictive value,and the lowest specificity.ROC curve analysis showed that the area under the ROC curve of DR-70(AUC=0.8655)in the diagnosis of CRC was the largest,the best cut-off value was 11.34 μg/mL,and the corresponding sensitivity and specificity were 87.1%and 70.7%,respectively.The sensitivity of DR-70 was the best than that of CEA,CA125,CA19-9,CA15-3,CA72-4.4.The sensitivity of DR-70 combined with conventional tumor biomarkers was significantly higher than that of single detection.The combined detection of DR-70,CEA,CA19-9,CA72-4 and the combined detection of DR-70,CEA,CA19-9,CA15-3,CA72-4 had the highest sensitivity and negative predictive value for CRC.Conclusion1.The expression level of DR-70 in CRC patients was significantly higher than that in patients with benign colorectal diseases and healthy people,which could be used as a reliable indicator for early screening and differential diagnosis of CRC.2.The expression of DR-70 was statistically significant with age,lesion location,clinical stage and distant metastasis,but not with gender.It suggested that DR-70 might become a tumor biomarker for monitoring disease progression in CRC patients.3.Compared with CEA,CA125,CA19-9,CA15-3 and CA72-4,DR-70 had the highest sensitivity and negative predictive value in diagnosing CRC,and the largest area under the ROC curve.The diagnostic value of DR-70 for CRC with high sensitivity and high accuracy was demonstrated.4.The combined detection of DR-70,CEA,CA19-9 and CA72-4 greatly improved the detection rate of CRC.Therefore,it was recommended that clinicians could use the combination of DR-70,CEA,CA19-9 and CA72-4 to assist the diagnosis of CRC.