目的：评价血清癌胚抗原（CEA）、糖类抗原-199（CA199）、和胸苷激酶l（TK1）联合检测在诊断结直肠癌中的诊断价值。方法：测定133例结直肠癌患者、103例良性肠病患者血清CEA、CA199和TK1水平，用Logistic回归模型制作ROC曲线，并且计算曲线下面积（AUCROC）以评价各肿瘤标志物的诊断价值。结果：结直肠癌组与良性肠病组的诊断性能评价，结直肠癌组的肿瘤标志物水平大于良性肠病组的肿瘤标志物，差异有统计学意义（Z=-5.185--4.241，P 均<0.05）。各ROC曲线下最佳cut-off值：CEA为3.36 ng/L、CA199为7.90 ng/L和TK1为1.51 pmol/L；各ROC曲线下面积：CEA为0.697，CA199为0.683，TK1为0.661，联合检测为0.757；联合检测的约登指数高。结论：血清CEA、CA199和TK1三项联合检测在结直肠癌的诊断中起到优势互补作用，三项联合检测可增加CRC诊断价值。%Objective:Aim The purpose of the present study was to evaluate the diagnostic efficiency for colorectal cancer (CRC) with the combined analysis of carcino-embryonic antigen (CEA), carbohydrate antigen 199 (CA199) and thymidine kinase 1 (TK1). Methods:Serum levels of CEA, CA199, and TK1 were measured in: 133 patients with CRC and 103 patients with benign colorectal diseases. The diagnostic value was analyzed using the logistic regression equation and receiver operating characteristic curves (ROC). Results:The serum levels of CEA, CA199, and TK1 in patients with CRC were significantly higher than those in patients with benign colorectal diseases (Z= -5.185 to -4.241,P<0.001 in all). Receiver operating characteristic curves (ROC) in patients with CRC versus those with benign colorectal diseases indicated the optimal cut-off value was 3.36 ng/L for CEA, 7.90 ng/L for CA199, and 1.51 pmol/L for TK1. The area under ROC curve (AUC) was 0.697 for CEA, 0.683 for CA199, 0.661 for TK1 and 0.757 for the combination of the tested tumor markers. The combination resulted in a higher Youden index.Conclusion:The conjoint detection of serum CEA, CA199, and TK1 could play complementary role in the diagnosis of CRC and could significantly improve the Youden index for the diagnosis of CRC.
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