Objective  To analyze the diagnostic value of serum carbohydrate antigen 19-9 (CA19-9), endothelial cell specific molecule 1 (ESM-1) and ratio of C-reactive protein (CRP) to albumin (ALB) in colorectal cancer and their relationships with clinicopathological features and survival time.

  Methods  Eighty-six patients with colorectal cancer were selected as colorectal cancer group, 50 patients with concurrent colorectal benign lesions were selected as benign lesion group, and 50 healthy subjects were selected as control group. Serum CA19-9, ESM-1 and CRP/ALB in three groups were detected; postoperative survival of colorectal cancer patients were followed up; diagnostic efficacy of CA19-9, ESM-1, CRP/ALB in colorectal cancer and their relationships with clinicopathological features and survival time were analyzed; prognostic risk factors were analyzed.

  Results  Serum CA19-9 and ESM-1 levels in the colorectal cancer group were significantly higher than those in the benign lesion group and control group (P < 0.05); the CRP/ALB in the colorectal cancer group was significantly higher than that in the benign lesion group, and was significantly higher in the benign lesion group than that in the control group (P < 0.05). The area under curve (AUC) of combined diagnosis of CA19-9, ESM-1 and CRP/ALB for colorectal cancer was 0.961, the sensitivity was 94.18%, and the specificity was 85.75%. CA19-9 was correlated with lymph node metastasis and distant metastasis (P < 0.05); ESM-1 was correlated with TNM stage and distant metastasis (P < 0.05); CRP/ALB was correlated with tumor differentiation, TNM stage, lymph node metastasis and distant metastasis (P < 0.05). The median survival time of patients with high levels of CA19-9, ESM-1 and CRP/ALB was significantly shorter than that of patients with low levels (P < 0.05). The degree of differentiation, TNM stage, distant metastasis, CA19-9, ESM-1 and CRP/ALB were prognostic influencing factors for colorectal cancer (P < 0.05).

  Conclusion  The joint detection of serum CA19-9, ESM-1 and CRP/ALB has a high diagnostic efficiency for colorectal cancer. They are all closely related to the occurrence and development of colorectal cancer, and affect the prognosis of patients.