摘要：目的 探讨大肠癌患者血清肿瘤标志物（CEA、CA19-9、CA242、CA50、CA72-4）的含量变化，联合多层螺旋CT（MSCT）检查，评价两者联合检测对大肠癌诊断的意义。方法 回顾性研究唐山市人民医院2012年7月至2014年5月间80例健康体检者、78例肠道良性病变患者（结肠炎30例，结、直肠息肉48例）、96例大肠癌患者（直肠癌50例，结肠癌46例）的肿瘤标志物含量及影像学变化，应用SPSS17.0软件进行统计分析。结果 大肠癌患者肿瘤标志物水平明显高于健康对照组及大肠良性病变组。肿瘤标志物联合诊断大肠癌的阳性率达93.75%，特异性为91.25%，优于单项肿瘤标志物检测；多层螺旋CT对大肠癌诊断的阳性率为91.67%，特异性为98.75%；大肠癌肿瘤标志物联合多层螺旋CT诊断大肠癌的阳性率可达100%，特异性91.25%，与健康对照组及大肠良性病变组比较，差异均具统计学意义（P<0.05）。结论 大肠癌肿瘤标志物、多层螺旋CT对大肠癌诊断各有优点及不足，两者联合检测有助于大肠癌的诊断及鉴别诊断。

Abstract：Objective To investigate clinical significance of the serum tumor markers (CEA, CA19-9, CA242, CA50, CA72-4) detection combined with multi-slice spiral CT examination in the diagnosis of colorectal cancer. Methods A retrospective study of the changes of tumor markers levels and CT image in 80 cases of healthy people, 78 cases of intestinal benign disease patients (30 cases of colitis, 48 cases of colon, rectum polyp), 96 cases of colorectal cancer (50 cases of colon cancer, 46 cases of rectal cancer) were carried out and SPSS17.0 software was used for statistical analysis. Results The serum tumor markers in patients with colorectal cancer were significantly higher than those in healthy control group and benign colorectal lesion. The positive rate of combined tumor markers detection in diagnosis of colorectal cancer was 93.75% and the specificity was 91.25%, it was better than single tumor marker detection. The positive rate of multi slice spiral CT in colorectal cancer diagnosis was 91.67% and the specificity was 98.75%. The positive rate of colorectal tumor markers combined with multi slice spiral CT in diagnosis of colorectal cancer was 100% and the specificity 91.25%, and it had statistically differences compared with healthy controls and benign colorectal lesion group (P<0.05). Conclusion The combined detection of tumor markers with multi-slice spiral CT could be helpful in differential diagnosis of colorectal cancer.