血红蛋白和血清铁对乙状结肠癌的诊断价值评估

摘要

目的 探讨血红蛋白和血清铁对乙状结肠癌的诊断价值.方法 收集2014年1月至2017年6月在解放军总医院手术治疗的乙状结肠癌患者139例、乙状结肠息肉99例和健康对照93例的临床资料,对受试者基本信息及血清指标进行统计分析.结果单因素统计分析显示术前红细胞计数(RBC)、红细胞比积(HCT)、血红蛋白(Hb)、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)、中性粒细胞(Neutrophil)、血清铁(SI)和不饱和铁结合力(UIBC)、血清铁蛋白(Ferritin)三组间比较差异有统计学意义(P＜0.05).SI在单一指标中诊断乙状结肠癌最优,ROC曲线下面积(AUC =0.84,95％CI:0.79 ～0.89),SI的临界值取16.7μmol/L,灵敏度为86.3％、特异性为66.7％.Hb+SI组合较为理想(AUC =0.86,95％ CI:0.81～0.91),灵敏度为86.3％,特异性为71.7％,二分类Logistic回归模型对乙状结肠癌的诊断准确率为78.2％.结论 血红蛋白和血清铁联合检测是较为理想的血液检测指标组合,有助于乙状结肠癌的早期筛查.%Objective To investigate the diagnostic value of hemoglobin and serum iron in sigmoid colon cancer.Methods Clinical data of 139 patients with sigmoid colon cancer who underwent operation,99 patients with sigmoid polyp and 93 normal controls in Chinese PLA general hospital from January 2014 to June 2017 were retrospectively analyzed.Results Univariateanalysis showed that there were significant differences in RBC,HCT,Hb,MCV,MCH,MCHC,neutrophil,SI,UIBCorFerritininamong three groups (all P ＜ 0.05).When the cutoff value of SI wasl6.7μmol/L,it had 86.3％ sensitivity and 66.7％ specificity[area under the curve (AUC) =0.84,95 ％ CI:0.79-0.89].The combined Hb + SIwas the optimal (86.3 ％ sensitivity and 71.7％ specificity,AUC =0.86,95％ CI:0.81-0.91).The diagnostic accuracy of the binarylogisctic analysis model for sigmoid colon cancerwas 78.2％.Conclusion The combination of hemoglobin and serum iron is more suitable as a diagnostic model for the screening of sigmoid colon cancer.