结直肠癌患者血清 D-dimer与 C-反应蛋白的检测及其临床意义

摘要

目的：评估结直肠癌（ colorectal carcinoma ，CRC）患者血清D-dimer与C-反应蛋白（ C-reactive protein ， CRP）检测的临床意义。方法收集53例CRC患者与30例健康者对照，患者术前及术后1、3、7 d采集血样，对照在体检时采集的血样；检测血清D-dimer与CRP并对淋巴结转移、血管浸润和TNM分级不同病理参数间检测值进行对比分析；对开腹手术和腹腔镜手术术后检测值进行对比分析；对患者术前CRP与D-dimer检测值进行相关性分析。结果 CRC患者D-dimer、CRP显著高于健康人群（P＜0．01）；淋巴结转移和血管浸润阳性患者D-dimer[（2．33±0．72） mg／L]与CRP[（16．0±1．5） mg／L]水平高于阴性患者（P＜0．01）；TNM分级各级患者间D-dimer与CRP水平有统计学差异，随病理等级增加而升高（P＜0．01）。 D-di-mer和CRP在术后均升高（P＜0．05），随后降低，D-dimer术后1周降至正常水平，而CRP在1周后仍高于术前水平（P＜0．05）。腹腔镜组CRP水平显著低于开腹手术组（P＜0．01）。术前CRP与D-dimer间具有正相关性（r＝0．432，P＜0．05）。结论血清D-dimer、CRP水平与CRC及其病变程度相关，可能对CRC的早期诊断、预后判断以及术后炎性反应判断具有指导意义。%Objective To evaluate the clinical significance of serum D-dimer and C-reactive protein ( CRP) detection in pa-tients with colorectal carcinoma .Methods Fifty-three patients and thirty healthy controls were enrolled and bloods were sampled from controls at examination and patients pre-operation and on days 1, 3, 7 post-operation respectively .Serum D-dimer and CRP were de-tected.The results were analyzed considering the pathologic parameters such as TNM staging , lymph nodes metastasis and vascular in-vasion.Contrastive analyses were performed between the measurements of laparoscopic and open resection cases .Results D-dimer and CRP levels in patients were significantly higher than in controls (P<0.01).D-dimer and CRP levels in patients with lymph nodes metastasis or vascular invasion were significantly higher than in negative cases .Serum D-dimer and CRP were increased by the TNM stages promotion .Serum D-dimer and CRP were both increased post-operation and then decreased .D-dimer was attenuated to normal level and CRP was still significantly higher than pre-operation at 7 days post-operation .CRP in patients undergoing laparoscopic resec-tion were significantly lower than in those undergoing open resection .Pre-operative CRP and D-dimer were positively correlated ( r=0.432,P<0.05).Conclusions Serum D-dimer and CRP are correlated with pathologic degrees in CRC;combined measurements of these two indexes may be significant in early diagnosis , prognosis and post-operative inflammation judgment in CRC .