The predictive value of CEA,CA724,CA199,FOBT and colorectal epithelial FH in the pathological classification of colorectal polyps
Objective To compare the serum CEA,CA724,CA199 levels and fecal FOBT,as well as colorectal FH positivity in patients with different colorectal polyps,and to explore the predictive value of these indexes for the patholog-ical classification of colorectal polyps.Methods A total of 235 patients with colorectal polyps in the Affiliated Digestive Hospital of Shandong First Medical University were selected and categorized into non-neoplastic polyps group,tubular adenoma with low-grade intraepithelial neoplasia group and tubular adenoma with high-grade intraepithelial neoplasia group based on pathological results.Serum CEA,CA724,CA199 levels,fecal FOBT,colorectal FH positive rates were compared in different groups.Multivariate Logistic regression analysis was further used to establish regression equations for the indicators with significant differences,and the optimal cut-off values for each index for high-grade intraepithelial neoplasia of tubular adenomatous polyps were calculated.Results The levels of serum CEA,CA724,CA199,fecal FOBT and colorectal FH in non-neoplastic polyp group,tubular adenoma with low-grade intraepithelial neoplasia group,tubular adenoma with high-grade intraepithelial neoplasia group were increased successively.The factors related to the high-grade intraepithelial neoplasia of tubular adenomatous polyps included the number of polyps,FOBT and FH.The AUC of the high-grade intraepithelial neoplasia of tubular adenomatous polyps was 0.754(95%CI:0.656-0.851,P<0.05),the best cut-off value was 0.346,with a sensitivity of 77.7%,specificity of 64.0%,and maximum Youden in-dex of 0.411.Conclusion Serum CEA,CA724,CA199 levels,fecal FOBT and colorectal FH positivity have certain screening value for the pathological types of colorectal polyps.Multiple polyps,positive FOBT and FH may serve as early predictors of intraepithelial neoplasia of tubular adenomatous polyps.
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