CLINICAL VALUE OF COMBINED DETECTION OF CA199, CEA AND HEAT SHOCK PROTEIN IN THE DIAGNOSIS OF RECTAL CANCER

Jun Zhang^#, Zongju Hu^#, Yuan Yao^*

Anorectal Ward, Department of General Surgery, Fuyang People's Hospital of Anhui Province, Fuyang 236000, PR China 

Objective: To analyze the clinical value of combined detection of carbohydrate antigen-199 (CA199), carcinoembryonic antigen (CEA), and heat shock protein 90 α (Hsp90α) in the diagnosis of rectal cancer.

Methods: 142 patients with rectal cancer treated in our hospital from January 2019 to 2020 were selected as the rectal cancer group, 56 patients with benign proctitis were selected as the benign lesion group, and 40 healthy people in the physical examination center of our hospital were selected as the healthy control group. According to Dukes stage, rectal cancer patients were divided into four groups: A, B, C, and D. According to the degree of differentiation, the patients were divided into four groups: high differentiation group, medium differentiation group, low differentiation group and undifferentiated group. The levels of CA199 and CEA were detected by chemiluminescence method, and serum Hsp90 α levels were detected by enzyme-linked immunosorbent assay (ELISA). The serum CEA, CA199, and Hsp90α levels were compared among all groups. The influencing factors of rectal cancer development were analyzed by univariate and multivariate Cox regression. ROC curve was used to analyze the value of CEA, CA199, and Hsp90α levels in the diagnosis of rectal cancer. 

Results: The serum levels of CEA, CA199, and Hsp90α in benign lesion group and rectal cancer group were significantly higher than those in healthy control group. Serum CEA, CA199, and Hsp90 α levels in rectal cancer group were significantly higher than those in benign lesion group (P<0.05). With the progress of Dukes staging, serum CEA, CA199, and Hsp90α levels in patients with rectal cancer were gradually increased (P<0.05). Serum CEA, CA199, and Hsp90α levels in patients with poorly differentiated and undifferentiated rectal cancer were significantly higher than those in patients with moderately differentiated and well-differentiated rectal cancer (P<0.05). By univariate and multivariate Cox regression analysis, CEA, CA199, and Hsp90α were the influencing factors for rectal cancer progression (P<0.05). ROC curve analysis showed that the AUC of CEA in the diagnosis of rectal cancer was 0.714, the sensitivity was 75.62%, and the specificity was 70.14%; the AUC of CA199 in the diagnosis of rectal cancer was 0.768, the sensitivity was 78.64%, and the specificity was 73.54%; the AUC of Hsp90α in the diagnosis of rectal cancer was 0.809, the sensitivity was 83.64%, the specificity was 81.07%; the AUC of the combination of CEA and CA199 was 0.876, the sensitivity was 89.64%, and the specificity was 86.37%. 

Conclusion: Serum levels of CEA, CA199, and Hsp90α are high in patients with rectal cancer, and they are closely related to Dukes stage and differentiation degree. They are influencing factors in the development and progression of rectal cancer, and they play a certain role in the diagnosis of rectal cancer. The combination of the three levels has the highest value and can be widely used in clinical practice.