| OBJECTIVE: To explore the association of peripheral blood tumor marker expression pattern from gastric and colon cancer patients before surgery,with the tumor staging and radical resection feasibility.Methods:1.Serum collection: Peripheral blood samples were collected with venipuncture before surgery,and serum was obtained by centrifugation.The samples were stored at-20°C until assay.2.Tumor marker concentration measurement: Tumor marker concentrations of CEA,CA199,CA125,CA724,CA153,and AFP were measured by enzyme-linked immunocytochemistry(i4100 light-emitting apparatus with chemiluminescence,Abbott Laborarories Ltd).The reagent Kits were provided by the same company.3.Statistics:Results:1.Consistency of the patient general clinical characteristics in the study with the data published from WHO In the gastric cancer group,the age incidence peaks at ages of 40 to 69,and there are significantly more male patients than female patients.In the colon cancer group,the age incidence peaks at ages of 50 to 79,and also there are significantly more male patients than female patients.2.The relationship between general clinical characteristics and radical resection feasibility of tumors In the gastric cancer group,there was no significant difference in the rate of radical resection between the tumors(P=0.299).However,there was a statistically significant difference in age stratification(P=0.01).The comparison between two groups showed that the radical resection rate of tumors of ages under 39 was significantly lesser than that of the ages of 40-69 and ages above 70.According to the spearman rank correlation test,there is no correlation between radical resection feasibility and age groups.(trend).Trend chi-square test suggests that there is a significant positive correlation between radical resection rate and tumor stage.The more advanced the tumor stage,the higher the tumor’s non-radical resection rate,The radical resection rate of tumor was statistically significant at the location of the tumor,P<0.001,which means that radical resection rate of cardia cancer was significantly greater than that of non-cardia cancer.In the colon cancer group,there was no significant difference in the rate of radical resection of the tumor between gender and age stratification(P>0.05).Spearman rank correlation test suggested that there is no correlation between radical resection feasibility and age.According to the trend chi-square test,there is a significant positive correlation between the rate of radical resection and tumor stage(P<0.001).The more advanced the tumor stage,the higher the tumor’s non-radical resection rate.The radical resection rate of tumor was statistically significant at the location of the tumor(P=0.0002),which indicated that the radical resection rate of left colon cancer was significantly greater than that of left colon cancer.3.Expression of tumor markers in preoperative serum and radical resection of gastric cancers and colon cancers Tumor markers of CEA,CA199,CA125,CA724,CA153,and AFP in the preoperative serum levels were simultaneously detected,and were determined to be positive expression when the concentration is over the normal range.Spearman rank correlation tests the relationship between the number of tumor markers positively expressed in the preoperative serum and the radical resection of gastric cancer and colon cancer.The results suggest that,in gastric cancer and colon cancer patients,the number of positively expressed tumor markers in the preoperative serum is negatively correlated with radical resection feasibility of the tumor.The correlation coefficient in gastric cancer is R=0.501,and the correlation coefficient in colon cancer is R=0.460.That is,in gastric cancer and colon cancer patients,the greater number of tumor markers positively expressed in preoperative serum,the higher risk of tumors not undergoing radical resection.4.Correlation between the preoperative serum expression of tumor markers with gastric and colon cancer staging The ralatedness between the number of tumor markers positively expressed in preoperative serum of colon cancer patients or gastric cancer patients and tumor stage was tested by the Goodman-Kruskal Gamma method,the result indicates that: In gastric cancer and colon cancer patients,there is a positive ralatedness between the number of tumor markers positively expressed in the preoperative serum and the tumor stage.The correlation coefficient in gastric cancer is γ=0.464,and the correlation coefficient in colon cancer is γ=0.514.In gastric cancer and colon cancer patients,the more tumor markers positively expressed in the preoperative serum,The higher risk of the later the tumor stage is.5.Correlation between the expression of tumor markers in preoperative serum and radical resection of gastric cancer and colon cancer.5.1 In preoperative serum,tumor markers CEA,CA199,CA125,CA724,CA153,AFP expression and radical resection of the tumor Analyzing the relationship between the expression of CEA,CA199,CA125,CA724,CA153,,AFP in preoperative serum and the radical resection of tumors,it was found that in patients with gastric cancer or colon cancer,patients with CA125 positively express in the serum Non-radical resection rate was significantly higher than those with other tumor marker positive expressions.To further determine the relationship between CA125 and radical resection of tumors.Analyzing the same number of tumor marker expression groups,whether there is a difference between the presence of CA125 positive expression and absence of CA125 positive expression in radical resection rate of tumors,chi-square test found that: In gastric cancer, regardless of the number of positive tumor markers expressed as 1,2,or ≥ 3,in those groups of presence of CA125 positive expression,the tumor non-radical resection rate was significantly greater than group of absence of CA125 positive expression.The P value was <0.05.In colon cancer,regardless of the number of positive tumor markers expressed as 1or 2,the tumor non-radical resection rate was significantly greater in the groups of presence of CA125 positive expression than that in those groups of absence of CA125 positive expression.The P value was <0.05.However,when the number of tumor markers positively expressed was ≥ 3,the reault shows the difference was not significant.P=0.4405.which meas whether a tumor present CA125-positive expression or not,there is a high risk of tumor could not be radically resected.5.2 CA125 value in preoperative serum and tumor radical resection The results of this experiment suggest that the positive expression of CA125 in preoperative serum is a relevant risk factor for the tumor cannot be resected radically,To further explore whether the CA125 positive expression value in preoperative serum is related to the radical resection of the tumor,through Wilcoxon test analysis showed that in patients with gastric cancer and colon cancer,the positive expression value of CA125 in preoperative serum had significant differences in the distribution of tumors for radical resection and non-radical resection.P=0.0024(for gastric cancer)and p=0.0384(for colon),respectively.Cancer group).By plotting the receiver-operating characteristic curve of CA125 positive expression value curibility of the tumor,it is suggested that the positive expression value of CA125 in the preoperative serum is higher in the non-radical resection group for tumors,and the predictability of CA125 is higher in the gastric cancer group than in the colon cancer group.the AUCs were 0.7727(gastric cancer group)and 0.6082(colon cancer group),respectively.By calculating the Youden index,the cut-off point for CA125 in the serum to determine whether the tumor can be radically resected was 73.35 U/ml in the gastric cancer group and 114.80 U/ml in the colon cancer group.The predictive value of CA125 cut-off point in gastric cancer and colon cancer was examined respectively.The results suggest that both the predictability of the value of CA125 cut-off point in preoperative serum of patients with gastric cancer and colon cancer are significance in predicting whether the radical resection surgery can be performed.Conclusion:1.In the gastric cancer group,the incidence is the highest at ages of 40 to 69;in the colon cancer group,the incidence is the highest at ages of 50 to 79.There are significantly more male patients than female patients in both group.2.Radical resection feasibility of gastric cancer and colon cancer is related to the tumor stage and location of the tumor.The more advanced the tumor stage,the greater the risk of tumors cannot be resected radically,and the risk of non-radical resection of tumors in the gastric cardia is lower than the non-cardiac tumors;in colon cancer,the risk of right colon cancer cannot be resected radically is higher than the left colon.In patients with gastric cancer less than 39 years of age,the risk of non-radical resection of tumors is higher than that in other age groups.However,in gastric cancer and colon cancer,there is no relatedness between the age and the curability of tumors3.In gastric cancer and colon cancer,the more positive number of tumor markers in preoperative serum,the higher risk of advanced tumor stage is,and the higher risk that the tumor cannot be resected radically.4.In gastric cancer and colon cancer,if the preoperative serum expression of CA125 exceeds the normal range,there is a higher risk of the tumor cannot be resected radically.5.In the gastric cancer and colon cancer groups,the positive expression values of tumor markers CEA,CA199,CA125,and CA724 in the serum are related to whether the tumor can undergo radical resection.When the positive expression value of the tumor marker is greater,The higher risk of the tumor cannot radical resection.In the gastric cancer group,the value of CA125 positive expression value is the most predictive factor for judging whether the tumor can undergo radical resection.In the colon cancer group,the CA199 positive expression value is the most predictive factor for judging whether the tumor can undergo radical resection.. |
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