Ultrasound/CT combined with serum CEA/CA19.9 in the diagnosis and prognosis of rectal cancer.

ABSTRACT

PURPOSE: To explore the significance of computed tomography (CT) and transrectal ultrasonography (TRUS) combined with serum CEA and CA19.9 in the staging, diagnosis and prognosis of rectal cancer. METHODS: Fifty-six patients with rectal cancer were recruited from our oncology department. ELISA detected the expression level of CEA and CA19.9 in serum. The hemodynamic parameters of the rectal mucosa and tumor were detected by TRUS [resistance index (RI), pulse index (PI), peak systolic velocity (PSV), end-diastolic volume (EDV)]. All patients were pathologically examined to determine the disease stage and to compare the diagnostic accuracy of serum tumor markers, CT and TRUS. All patients were followed up for 24 months to assess the relationship between the combined examinations and the disease prognosis. RESULTS: CEA and CA19.9 levels were significantly different in patients with different pathological stages (p<0.05). RI and PI decreased with increasing pathological stage, while PSV and EDV were increased with increasing pathological stage. The serum CEA+CA19.9 examination showed 12 cases of misdiagnosis, with an accuracy diagnostic rate of 78.57% (447sol;56). CT examination showed 8 cases of misdiagnosis, with an accuracy diagnostic rate of 85.71% (48/56). TRUS showed 6 cases of misdiagnosis, with an accuracy diagnostic rate of 89.28% (50/56). However, only 2 cases were misdiagnosed and 96.43% (54/56) were accurate, while no statistical difference was noticed between combined detection and pathology (p<0.05). Postoperative follow-up showed significant differences in T staging at 6 months, 1 year and 2 years after operation (p<0.05). CONCLUSION: CT and TRUS combined with serum CEA and CA19.9 had great value in the diagnosis and prognosis in rectal cancer.